Remote Aetna Case Manager - Ohio (Up to $30/Hour)

Remote Full-time
We are seeking an experienced and skilled Aetna Case Manager to join our team at Workwarp. As a Case Manager, you will play a crucial role in managing federal medical insurance and long-term care lines of business. This is a remote opportunity with a competitive salary and immediate start date available. The successful candidate will assist the Chief Operating Officer (COO) in the successful development and execution of the program, including financial management, interface, collaboration, and cooperation with corporate office functional leaders and unified shared services business divisions. The ideal candidate will have a deep understanding of case management systems and processes, value-based contracts, and compliance programs. Key Responsibilities: • Manage the federal medical insurance and long-term care lines of business • Provide timely, accurate, and complete reports on the operational status of the program • Develop policies and procedures for assigned areas and ensure that other affected areas review new and changed policies • Assist the COO in collaborative efforts related to the development, communication, and execution of effective growth strategies and processes • Lead the implementation of new projects, services, and preparation of proposed and award proposals • Collaborate with the program management team and others to develop and implement action plans for the operational infrastructure of systems, processes, and staff • Participate in the development and execution of marketing plans for the program and ensure compliance with program guidelines • Assist in defining marketing and advertising strategies within state guidelines • Ensure compliance with regulations, rules, and guidelines, company policies, and procedures for every assigned area Requirements: • Residence in Ohio (relocation package available for qualified candidates) • Ability to work in a hybrid model (in-office Tuesday, Wednesday, Thursday) • Proven experience in government programs like Medicaid, Medicare, or Dual Eligibles, including government contracts, legal, and compliance background • Deep understanding of case management systems and processes, value-based contracts, and compliance programs • Knowledge of credentialing, provider relations, network development, and supplier information • High awareness of the marketing of Medicaid, communications to members and providers, community programs, and social determinants of health (SDOH) • Ability to work collaboratively across multiple teams, prioritize requests, integrate information, and draw meaningful conclusions • Proven leadership experience with relevant initiatives: business process improvement, project management, financial strategic planning, and risk management If you are a motivated and experienced professional looking for a new challenge, we encourage you to apply for this exciting opportunity. Please submit your application today and let's build the future together! Apply Now | Learn More and Apply Apply for this job Apply tot his job
Apply Now

Similar Opportunities

Experienced Registered Behavior Technician for In-Home ABA Therapy - Atlanta, GA

Remote Full-time

Immediate Hiring: Experienced Registered Behavioral Technician (RBT) for Clinic-Based ABA Therapy Services

Remote Full-time

Experienced Registered Behavioral Technician (RBT) - ABA Therapy for Children with Autism Spectrum Disorder

Remote Full-time

Experienced Registered Nurse - Telehealth: Providing Remote Care Coordination and Patient Support

Remote Full-time

Experienced Substitute Teacher for Riverside County Schools - Join Scoot Education's Innovative Team

Remote Full-time

Experienced Substitute Teacher for San Bernardino County - Flexible Schedules & Competitive Pay

Remote Full-time

Experienced School Year Instructional Coach for High-Dosage Tutoring Programs in Edgewater Park, NJ

Remote Full-time

Experienced School Year Tutor for K-8 Students in Math and Literacy - Mickleton, NJ

Remote Full-time

Experienced Secondary Social Studies Teacher for Kansas - Flexible Hybrid Remote Arrangement

Remote Full-time

USPS Office Helper

Remote Full-time

Hybrid Community Health Dental Hygienist

Remote Full-time

[Remote] Optical Learning Experience Designer

Remote Full-time

Experienced Online English Tutor – Remote Work Opportunity in Annapolis, MD, with Flexible Scheduling and Competitive Compensation

Remote Full-time

Franchisee Partner Support & Account Manager

Remote Full-time

Entry Level arenaflex Remote Jobs (Data Entry) $75000/Yearly – WFH

Remote Full-time

Experienced Sensor Test and Characterization Engineer for Advanced Biotechnology Product Development

Remote Full-time

Health Information Management Outpatient Coding Auditor Senior, FT, Days, - Remote

Remote Full-time

Case Manager, Registered Nurse - Fully Remote

Remote Full-time

Sr Technical Service Advisor

Remote Full-time

Business Development Representative

Remote Full-time
← Back to Home