Description
We're building a world of health around every individual , shaping a more connected, convenient and compassionate health experience.
Join our Aetna team as an industry leader in serving dual eligible populations by utilizing best-in-class operating and clinical models. As an Integrated Care Management (ICM) Care Manager, you will be a frontline advocate for members who cannot advocate for themselves. Your responsibilities will include:
- Assessing, planning, implementing, and coordinating all case management activities with members to evaluate their medical needs and facilitate their overall wellness.
- Developing a proactive plan of care to address identified issues and enhance short and long-term outcomes.
- Using clinical tools and information/data review to conduct an evaluation of members' needs and benefits.
- Applying clinical judgment to incorporate strategies designed to reduce risk factors and barriers and address complex health and social indicators which impact care planning.
- Conducting assessments that consider information from various sources, such as claims, to address all conditions including co-morbid and multiple diagnoses that impact functionality.
- Collaborating with supervisors and other key stakeholders in the member's healthcare to overcome barriers in meeting goals and objectives.
- Utilizing case management processes in compliance with regulatory and company policies and procedures.
Required Qualifications:
- Minimum 3+ years of clinical practice experience
- Active and unrestricted RN license in the state of NJ
- Willing and able to travel 25-50% of their time using your own vehicle to meet members face-to-face in their assigned area.
- Must reside in Ocean or surrounding County, NJ
Preferred Qualifications:
- Certified Case Manager is preferred.
- Minimum 2+ years Care Management, Discharge Planning and/or Home Health Care Coordination experience preferred.
- Confidence working at home/independent thinker, using tools to collaborate and connect with teams virtually.
- Excellent analytical and problem-solving skills.
- Effective communications, organizational, and interpersonal skills.
- Ability to work independently.
- Effective computer skills including navigating multiple systems and keyboarding.
- Demonstrates proficiency with standard corporate software applications, including MS Word, Excel, Outlook, and PowerPoint, as well as some special proprietary applications.
- Bilingual Preferred.
Education:
- Associate’s Degree in Nursing.
- Bachelor's Degree Preferred.
Anticipated Weekly Hours: 40
Time Type: Full-time
Pay Range: $66,575.00 - $142,576.00
Benefits: We offer a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families. 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.