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Field Case Mgr-Medical

at Aetna Inc.

Posted: 7/25/2019
Job Reference #: 65908

Job Description

Job Description
Candidates must be located in one of the following areas of NC due to local travel involved: Cary, Durham, or Raleigh.

Aetna Case Management is a member centric, team-delivered, community based care management model that joins members where they are. The Field Case Manager works collaboratively with an interdisciplinary team in the process of assessment, planning, facilitation, care coordination, evaluation, and advocacy. The Field Case Manager connects members to the resources and services, available in their own community, to support the members comprehensive health needs while promoting quality care and cost effective outcomes.


Req#
61695BR

Job Group
Healthcare

Full or Part Time
Full Time

Supervisory Responsibilities
No

Percent of Travel Required
50 - 75%

Posting Job Title
Field Case Mgr-Medical

Potential Telework Position
Yes

Additional Locations
NC-Cary, NC-Durham, NC-Raleigh

Primary Location (City, State)
NC-Cary

EEO Statement
Aetna is an Equal Opportunity, Affirmative Action Employer

Resource Group
6

Initiative Group
93

Additional Job Information
This is an exceptional opportunity for case management of Medicare members, in collaboration with MDT- Nurse Case Manager, Medical Director, Social Worker, Pharmacist, and Behavioral Health to develop creative case plans with traditional and non-traditional resources. There are available educational opportunities to meet both personal and professional goals. We have a culture of value-driven team

Fundamental Components
Responsible for case management of eligible Aetna members with complex care needs; partners with an interdisciplinary team to deliver comprehensive, community-based case management services focused on helping the member maximize best health outcomes. Interacts with members in-person, in their home on a regular basis; also meets members at an agreed upon community location such as a library. Interacts with members telephonically following at least the minimum standard of contact required per member based on their level of intervention. Conducts in-person, individualized assessments to identify problems, goals, & interventions with corresponding measurable outcomes that drive the content of the holistic, member centered care plan. Develops a healthy action plan in partnership with the member, defining problems, goals, and objectives to improve the members overall wellbeing/quality of life, continuously partners with the member to evaluate the member’s progress in setting/meeting the established goals, and revising/updating the health action plan accordingly. Utilizes influencing and motivational interviewing skills to ensure maximum member engagement; promotes lifestyle and behavior changes to achieve optimum level of health. Helps members actively and knowledgeably participate with providers in healthcare decision-making; helps members actively and knowledgeably participate with community based organizations able to support in meeting health goals. Conducts assessments for members discharged from an in-patient hospital or skilled nursing facility supports post discharge plan of care for both members assigned within their case load and members outside of the case load but residing within their local community. Demonstrates proficiency with operating in a remote environment, connecting hardware/software, managing email in an Outlook account, and using remote communication software such as Skype & WebEx; able to demonstrate proficiency with Word, Excel, and experience documenting within an electronic health record. Other requirements include: ability to flex work hours to meet the member scheduling needs, ability to travel within a designated geographic area for in-person care management activities distance is reasonable but not fully defined by one-way mileage limits.


Background Experience
RN licensure required
5+ years clinical experience required
1+ years of either home health or case management experience required

Ability to travel within a designated geographic area for in-person case management activities required

Managed care experience preferred
CCM preferred
Excellent analytical and problem solving skills
Effective communications, organizational, and interpersonal skills
Proficiency with standard corporate software applications, including MS Word, Excel, Outlook and PowerPoint, as well as some special proprietary applications
Effective computer skills including navigating multiple systems and keyboarding


Minimum Education Level
Nursing - Registered Nurse

Benefits Program
Benefit eligibility may vary by position. Click here to review the benefits associated with this position.

Candidate Privacy Information
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