Working At Aetna -- the Value To You What does it mean to work at Aetna? A lot. From programs and benefits that support your financial, physical and emotional health to opportunities to build your knowledge and expand your career, the company makes working here a valuable experience in many ways.
This position is located in Aetna's Downtown Chicago office.
POSITION SUMMARY
The Case Manager utilizes a collaborative process of assessment, planning, facilitation and advocacy for options and services to meet an individuals benefit plan and/or health needs through communication and available resources to promote optimal, cost-effective outcomes. Requires an RN with unrestricted active license.
The CM process includes: assessing the member's health status and care coordination needs, inpatient review and discharge planning, developing and implementing the CM plan, monitoring and evaluating the plan and involving the Medical Director as indicated and closing the case as appropriate when the member has met discharge criteria. The responsibilities of this position are to apply data driven methods of identification of members to fashion individualized case management programs and/or referrals to alternative healthcare programs. Conducts comprehensive clinical assessments. Evaluates needs and develops flexible approaches based on member needs, benefit plans or external programs/services. Advocates for patients to the full extent of existing health care coverage. Promotes quality, cost effective outcomes and makes suggestions to improve program/operational efficiency. Identifies and escalates quality of care issues through established channels. Expectation is a very high level of customer service.
Required Skills:
EDUCATION
The highest level of education desired for candidates in this position is a Bachelor's degree.
LICENSES AND CERTIFICATIONS
Nursing/Registered Nurse (RN) is required
REQUIRED SKILLS
Finance/Managing Aetnas Risk
General Business/Consulting for Solutions
Benefits Management/Maximizing Healthcare Quality
Organ Transplant Experience
Behavioral/Mental Health Experience
Computer Skills
FUNCTIONAL EXPERIENCES
Nursing/Case Management/Managed Care experience5-8 Years
Nursing/Disease Management/1-3 Years
Nursing/Discharge Planning/5-8 Years
Nursing/Transplant experience/1-3 Years
Nursing/Behavioral Health/5-8 Years
Please note that benefit eligibility may vary by position. Click here to review the benefits associated with this position.
Aetna does not permit the use of tobacco related products or drugs in the workplace.
How to apply
Please use the "Apply" link to apply to this position. If you cannot view this link, you can find this position on our website by visiting: www.aetna.com/working, click on apply online, search openings, and enter 8848BR in the keyword field. Additional information on what it’s like to work for Aetna and more can also be found on our website.
We value leadership, creativity and initiative. If you share those values and a commitment to excellence and innovation, consider a career with Aetna.
We conduct pre-employment drug and background testing.
Aetna does not permit the use of tobacco related products or drugs in the workplace.
Aetna is an Equal Opportunity/Affirmative Action Employer. M/F/D/V
Aetna is committed to maintaining an environment in which all employees are treated equitably and given the opportunity within the context of the business to achieve their potential. Aetna's Affirmative Action responsibilities extend to women, minorities, persons with disabilities and veterans. Company policy also provides for equal opportunity for qualified individuals regardless of race, color, sex, national origin, religion, age, disability, veteran status, sexual orientation, gender identity or marital status.
No search firms please.
You will not be asked for personal information until you have been fully evaluated through Aetna's screening processes. Aetna will never ask applicants for money. If you want to verify the identity of someone who contacts you from Aetna, call 1-800-AETNAHR (1-800-238-6247).
Aetna - 11 months ago
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