Registered Nurse, Case Manager
Job Description:
• 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 member’s overall wellness through integration
• Conducts an evaluation of member’s needs and benefit plan eligibility and facilitates integrative functions as well as smooth transition to Aetna programs and plans
• Applies clinical judgment to the incorporation of strategies designed to reduce risk factors and barriers and address complex health and social indicators which impact care planning and resolution of member issues
• Assessments take into account information from various sources to address all conditions including co-morbid and multiple diagnoses that impact functionality
• Reviews prior claims to address potential impact on current case management and eligibility
• Using a holistic approach assess the need for a referral to clinical resources for assistance in determining functionality
Requirements:
• Must reside in MST, PST, or CST
• Must have an active current and unrestricted RN license in state of residence
• Willingness and ability to obtain additional state licenses upon hire (paid for by the company)
• 3+ years of acute hospital clinical experience as an RN (general medical, post-surgical, ICU experience)
• 1+ years of case management and/or Home Health experience preferred
• Compact RN licensure preferred
• Certified Case Manager (CCM) certification preferred
• Experience with all types of Microsoft Office including PowerPoint, Excel, and Word
• Strong telephonic communication skills
Benefits:
• Affordable medical plan options
• 401(k) plan (including matching company contributions)
• Employee stock purchase plan
• No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching
• Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility
Apply tot his job
Apply To this Job
• 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 member’s overall wellness through integration
• Conducts an evaluation of member’s needs and benefit plan eligibility and facilitates integrative functions as well as smooth transition to Aetna programs and plans
• Applies clinical judgment to the incorporation of strategies designed to reduce risk factors and barriers and address complex health and social indicators which impact care planning and resolution of member issues
• Assessments take into account information from various sources to address all conditions including co-morbid and multiple diagnoses that impact functionality
• Reviews prior claims to address potential impact on current case management and eligibility
• Using a holistic approach assess the need for a referral to clinical resources for assistance in determining functionality
Requirements:
• Must reside in MST, PST, or CST
• Must have an active current and unrestricted RN license in state of residence
• Willingness and ability to obtain additional state licenses upon hire (paid for by the company)
• 3+ years of acute hospital clinical experience as an RN (general medical, post-surgical, ICU experience)
• 1+ years of case management and/or Home Health experience preferred
• Compact RN licensure preferred
• Certified Case Manager (CCM) certification preferred
• Experience with all types of Microsoft Office including PowerPoint, Excel, and Word
• Strong telephonic communication skills
Benefits:
• Affordable medical plan options
• 401(k) plan (including matching company contributions)
• Employee stock purchase plan
• No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching
• Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility
Apply tot his job
Apply To this Job