Case Manager Analyst - Field

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Position Summary – Case Manager Analyst - Field

This Case Management Analyst Field position is with Aetna's Long-Term Services & Supports (LTSS) team and is a field-based position out of Lake County Illinois. The requirement is for candidates to travel 50-75% of the time to meet with members face to face. This position holds a full caseload to manage waiver members. This position requires in-person quarterly visits with members.

Evaluation of Members: Through the use of care management tools and information/data review, conducts comprehensive evaluation of referred member's needs/eligibility and recommends an approach to case resolution and/or meeting needs by evaluating member's benefit plan and available internal and external programs/services.

Enhancement of Medical Appropriateness and Quality of Care: Using a holistic approach, consults with case managers, supervisors, Medical Directors and/or other health programs to overcome barriers to meeting goals and objectives; presents cases at case conferences to obtain multidisciplinary review in order to achieve optimal outcomes.

Monitoring, Evaluation and Documentation of Care: Utilizes case management and quality management processes in compliance with regulatory and accreditation guidelines and company policies and procedures.

Required Qualifications:

• Must reside in the state of Illinois in Lake or DuPage County Illinois
• Valid Illinois Driver's license
• Must possess reliable transportation and be willing and able to travel up to 75% of the time. Mileage is reimbursed per our company expense reimbursement policy
• Minimum of two (2) years of case management experience
• Microsoft Office and electronic health record experience

Preferred Qualifications:

• Discharge planning experience
• Managed Care experience
• Multi-lingual language proficiency

Required Education:

• Individual with a bachelor's degree or a non-licensed individual with a master's degree, with either degree being in a human-services field (including, but not limited to sociology, special education, rehabilitation counseling)

Benefits: This full-time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial well-being of colleagues and their families. The benefits for this position include medical, dental, and vision coverage, paid time off, retirement savings options, wellness programs, and other resources, based on eligibility.