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Aetna Inc.

Case Manager RN

Aetna Inc. - Allentown, PA

Job Description
POSITION SUMMARY Please note: Training hours will be 8AM-4:30PM for a period of 8-12 weeks. Once completed, required shift is 1:30PM - 10PM, Monday - Friday. This Case Management position is for the Public and Labor Program. 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. Fundamental Components: Fundamental Components related to Aetna In Touch Care Program include but are not limited to:Utilizes influencing/motivational interviewing skills to ensure maximum member engagement to achieve optimal outcomes, Utilizes assessment techniques to determine members level of health literacy, technology capabilities, and/or readiness to change.Utilizes influencing/motivational interviewing skills to ensure maximum member engagement and promote lifestyle/behavior changes to achieve optimum level of health.Provides coaching, information and support to empower the member to make ongoing independent medical and/or healthy lifestyle choices. BACKGROUND/EXPERIENCE desired: Requires an RN with unrestricted active license. 3 years Medical Surgical experience is required Strong computer and typing skills are required Must be comfortable with navigation through multiple systems and dual monitors and must be able to touch type at efficient speed. Experience with patient education and Discharge planning is preferred Bilingual in English and Spanish is preferred. Disability case management experience preferred . EDUCATION The minimum level of education desired for candidates in this position is a Associate's degree or equivalent experience. LICENSES AND CERTIFICATIONS Nursing/Registered Nurse is required Nursing/Certified Case Manager (CCM) is preferred FUNCTIONAL EXPERIENCES Functional - Nursing/Medical-Surgical Care/3 Years Functional - Nursing/Case Management/1 Years TECHNOLOGY EXPERIENCES Technical - Desktop Tools/Microsoft Outlook/1 Years/End User Technical - Desktop Tools/Microsoft Explorer/1 Years/End User Technical - Aetna Applications/Aetna Total clinical View/1 Years/End User REQUIRED SKILLS General Business/Consulting for Solutions/ADVANCED Leadership/Collaborating for Results/ADVANCED Benefits Management/Maximizing Healthcare Quality/FOUNDATION ADDITIONAL JOB INFORMATION We are looking for a Case Manager to join the Allentown Dedicated Unit. Aetna In Touch Care model will be a combined case management and disease management focus. In this CM/DM role we are looking for a candidate who will assist with health care coordination, member satisfaction, and financial outcomes using targeted customer strategies and initiatives. The CM will provide telephonic member outreach for key educational and situational opportunities for increased case management and disease management identification and engagement. We will provide decision support and guidance for members and their families along with coordination of healthcare services. 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. Minimum 3 to 5 years of recent experience. Strong knowledge of major health behavior models including Motivational Interviewing preferred. Must possess strong verbal, written communication skills, computer and keyboarding skills. Aetna is about more than just doing a job. This is our opportunity to re-shape healthcare for America and across the globe. We are developing solutions to improve the quality and affordability of healthcare. What we do will benefit generations to come. We care about each other, our customers and our communities. We are inspired to make a difference, and we are committed to integrity and excellence. Together we will empower people to live healthier lives. Aetna is an equal opportunity & affirmative action employer. All qualified applicants will receive consideration for employment regardless of personal characteristics or status. We take affirmative action to recruit, select and develop women, people of color, veterans and individuals with disabilities. We are a company built on excellence. We have a culture that values growth, achievement and diversity and a workplace where your voice can be heard. Benefit eligibility may vary by position. Click here to review the benefits associated with this position. Aetna takes our candidate's data privacy seriously. At no time will any Aetna recruiter or employee request any financial or personal information (Social Security Number, Credit card information for direct deposit, etc.) from you via e-mail. Any requests for information will be discussed prior and will be conducted through a secure website provided by the recruiter. Should you be asked for such information, please notify us immediately.Aetna is an Equal Opportunity, Affirmative Action Employer

10 days 13 hours ago

Aetna Inc.


Case Manager RN Aetna Inc. - Allentown, PA, United States


Location: Allentown, PA

Company Profile:
Aetna Inc. operates as a diversified health care benefits company in the United States. The company operates in three segments: Health Care, Group Insurance, and Large Case Pensions. The Health Care segment provides medical, pharmacy benefit management, dental, behavioral health, and vision plans on an insured basis, and an employer-funded or administrative basis. This segment also provides Medicare and Medicaid products and services, as well as other medical products, such as medical management and data analytics services, medical stop loss insurance, workers' compensation administrative services, and products that provide access to its provider networks in select markets. This segment offers its products and services to multi-site national, mid-sized, and small employers, as well as individual customers. The Group Insurance segment provides life insurance products comprising group term life insurance, voluntary spouse and dependent term life insurance, group universal life, and accidental death and dismemberment insurance; disability insurance products; and long-term care insurance products, which offer benefits to cover the cost of care in private home settings, adult day care, assisted living, or nursing facilities. This segment provides insurance products principally to employers that sponsor its products for the benefit of their employees and their employees’ dependents. The Large Case Pensions segment manages various retirement products, including pension and annuity products for tax-qualified pension plans. The company’s customers include employer groups, individuals, college students, part-time and hourly workers, health plans, health care providers, governmental units, government-sponsored plans, labor groups, and expatriates. Aetna Inc. was founded in 1853 and is headquartered in Hartford, Connecticut.