Case Management Coordinator

We're building a world of health around every individual , shaping a more connected, convenient and compassionate health experience.

As a Case Management Coordinator with Aetna's Long-Term Services and Supports (LTSS) team, you will facilitate appropriate healthcare outcomes for members by providing care coordination, support and education for members through the use of care management tools and resources.

Responsibilities:

• Conduct comprehensive evaluations of referred members' needs and eligibility using care management tools and information/data review
• Recommend approaches to case resolution and/or meeting needs by evaluating members' benefit plans and available internal and external programs/services
• Identify high-risk factors and service needs that may impact member outcomes and care planning components
• Coordinate and implement assigned care plan activities and monitor care plan progress
• Consult with case managers, supervisors, Medical Directors and/or other health programs to overcome barriers to meeting goals and objectives
• Present cases at case conferences to obtain multidisciplinary review in order to achieve optimal outcomes
• Identify and escalate quality of care issues through established channels
• Utilize negotiation skills to secure appropriate options and services necessary to meet the member's benefits and/or healthcare needs
• Provide coaching, information and support to empower the member to make ongoing independent medical and/or healthy lifestyle choices
• Help members actively and knowledgeably participate with their provider in healthcare decision-making
• Utilize case management and quality management processes in compliance with regulatory and accreditation guidelines and company policies and procedures

Requirements:

• Minimum 2 years of experience in behavioral health, social services or human services field
• Minimum 2 years of case management experience
• Must reside in Macon County IL
• Must possess reliable transportation and be willing and able to travel up to 50-75% of the time to meet members face-to-face in Macon County and surrounding areas
• Active Driver's License, preferably out of IL

Preferred Qualifications:

• Case management and discharge planning experience
• Managed Care experience
• Microsoft Office experience

Education:

• Bachelor's degree or non-licensed master-level clinician required, with either degree being in behavioral health or human services required (psychology, social work, marriage and family therapy, counseling)

Anticipated Weekly Hours: 40

Time Type: Full-time

Pay Range: $21.10 - $44.99

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.