A1A Precertification Nurse Case Manager (RN)
A1A (Aetna One Advocate) is a fully integrated population health and customer service solution for large plan sponsors. Our embedded and customer-dedicated service, clinical, and rising risk pods allow maximization of inbound and outbound touchpoints to solve members needs and create behavior change. Our white-glove service and end-to-end ownership of member support creates a trusted partner in health. We are the premiere service and clinical offering for Aetna nation-wide and create industry-leading solutions for our customers and members. A Precertification Nurse Case Manager is responsible for telephonically assessing, planning, implementing and coordinating all case management activities with members to evaluate the medical needs of the member to facilitate the members overall wellness. Develops a proactive course of action to address issues presented to enhance the short and long-term outcomes as well as opportunities to enhance a members overall wellness through integration. Services strategies policies and programs are comprised of network management and clinical coverage policies. This role is office based in High Point, NC. The required hours are Monday- Friday 8:00am- 4:30pm EST with evening shift rotation approximately 2 times per month. Apply tot his job