Registered Nurse (RN) - Case Manager
Aetna 625 reviews - South Portland, ME

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Teleworker opportunity exists after aroudn 6 weeks of training in this position and satisfactory performance. The candidate must be located within commuting distance to Aetna''s Blue Bell, PA; South Portland, ME; or Hartford, CT offices.POSITION SUMMARYFlexible Medical Model Case Management is a nurse focused, health care coordination program that improves plan sponsor service, member satisfaction, and financial outcomes using targeted customer strategies and initiatives. Accountable for implementation and monitoring of data driven initiatives and strategies that: guide and support regional care management interventions; provide value-added opportunities for member outreach; enhance and support plan sponsor participation in health care decisions. The nurse consultant utilizes clinical skills in a collaborative process to assess, plan, implement, coordinate, monitor and evaluate options and services to facilitate appropriate healthcare outcomes for members.Act as a plan sponsor subject matter expert for Regional Care Teams providing care coordination for targeted plan sponsors. Provide proactive member outreach for key educational and situational opportunities for increased case management and disease management identification. Collaborate with care teams, National Medical Excellence, Disease Management, Maternity Management, Behavioral Health, and disability to assure coordination of healthcare services, decision support and guidance for members and their families. EDUCATIONThe highest level of education desired for candidates in this position is a Bachelor''s degree or equivalent experience.LICENSES AND CERTIFICATIONSNursing/Certified Case Manager (CCM) is desiredNursing/Registered Nurse (RN) is requiredFUNCTIONAL EXPERIENCESFunctional -Nursing/Case Management/1-3 YearsFunctional - Nursing/Discharge Planning/1-3 YearsFunctional - Nursing/Medical-Surgical Care/1-3 YearsFunctional - Nursing/Home Health Care Ambulatory Nursing/1-3 YearsTECHNOLOGY EXPERIENCESTechnical - Desktop Tools/Microsoft Explorer/1-3 YearsTechnical - Desktop Tools/Microsoft Outlook/1-3 YearsTechnical - Desktop Tools/Microsoft Word/1-3 YearsREQUIRED SKILLSTechnology/Leveraging TechnologyBenefits Management/Maximizing Healthcare QualityBenefits Management/Understanding Clinical ImpactsDESIRED SKILLSBenefits Management/Supporting Medical PracticeLeadership/Driving a Culture of ComplianceLeadership/Fostering a Global PerspectivePlease note that benefit eligibility may vary by position. Clickhereto review the benefits associated with this position.
Aetna does not permit the use of tobacco related products or drugs in the workplace.
Job Function: Health Care

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625 reviews
Life, death, health, or injury -- Aetna's got an insurance policy to cover it. The company, one of the largest health insurers in the...