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Registered Nurse (RN) Case Manager
•30 days ago
| Hours | Full-time, Part-time |
|---|---|
| Location | High Point, North Carolina |
About this job
POSITION SUMMARY
The Case Manager works for a single account in a collaborative environment. Through the process of assessment, planning, and advocacy the case manager will help the member achieve their highest level of health in the most appropriate and cost-effective setting. Case Manager is needed with Oncology experience. All member/provider contact is by phone or electronic media with an expectation that timeliness standards are met. This is an in office position that will required 2-3 evenings a month from 12:30PM to 9:00 PM.
Fundamental Components
The Case Manager is responsible for telephonically assessing, planning, implementing and coordinating all case management activities with members to evaluate the medical needs, overall wellness and/or appropriate and timely return to work. The case manager develops a proactive course of action to enhance short and long term outcomes as well as identifying opportunities to enhance a members overall wellness through integration with partner programs.
BACKGROUND/EXPERIENCE
Current, unrestricted RN license - Minimum of 4 years diverse clinical background
- Case Management and/or Managed Care experience a plus
- Strong technical and computer skills are a must.
EDUCATION
The highest level of education desired for candidates in this position is a Bachelor's degree or equivalent experience.
LICENSES AND CERTIFICATIONS
Nursing/Certified Case Manager (CCM) is desired
Nursing/Registered Nurse (RN) is required
FUNCTIONAL EXPERIENCES
Functional - Nursing/Case Management/4-6 Years
TECHNOLOGY EXPERIENCES
Technical - Operating Systems/Windows/1-3 Years/End User
REQUIRED SKILLS
Benefits Management/Maximizing Healthcare Quality/FOUNDATION
Service/Providing Solutions to Constituent Needs/ADVANCED
DESIRED SKILLS
Benefits Management/Understanding Clinical Impacts/FOUNDATION
General Business/Consulting for Solutions/ADVANCED
General Business/Turning Data into Information/FOUNDATION
ADDITIONAL JOB INFORMATION
Managed care experience a plus. - This position is in an office environment using a computer station and may require sitting for extended periods of time. - Candidate must possess good computer skills. - This is ideal for an applicant seeking a fast paced environment. . Full Time position, M-F, requiring 2 or 3 times a month a shift until 9:00pm. Will be located at 4050 Piedmont Parkway. No opportunity for work at home, so looking for someone who enjoys working in an office in a high energy and motivated team environment.
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.
We conduct pre-employment drug and background testing. Benefit eligibility may vary by position. Click here to review the benefits associated with this position.
Employment Type Regular Career Band Description Professional
The Case Manager works for a single account in a collaborative environment. Through the process of assessment, planning, and advocacy the case manager will help the member achieve their highest level of health in the most appropriate and cost-effective setting. Case Manager is needed with Oncology experience. All member/provider contact is by phone or electronic media with an expectation that timeliness standards are met. This is an in office position that will required 2-3 evenings a month from 12:30PM to 9:00 PM.
Fundamental Components
The Case Manager is responsible for telephonically assessing, planning, implementing and coordinating all case management activities with members to evaluate the medical needs, overall wellness and/or appropriate and timely return to work. The case manager develops a proactive course of action to enhance short and long term outcomes as well as identifying opportunities to enhance a members overall wellness through integration with partner programs.
BACKGROUND/EXPERIENCE
Current, unrestricted RN license - Minimum of 4 years diverse clinical background
- Case Management and/or Managed Care experience a plus
- Strong technical and computer skills are a must.
EDUCATION
The highest level of education desired for candidates in this position is a Bachelor's degree or equivalent experience.
LICENSES AND CERTIFICATIONS
Nursing/Certified Case Manager (CCM) is desired
Nursing/Registered Nurse (RN) is required
FUNCTIONAL EXPERIENCES
Functional - Nursing/Case Management/4-6 Years
TECHNOLOGY EXPERIENCES
Technical - Operating Systems/Windows/1-3 Years/End User
REQUIRED SKILLS
Benefits Management/Maximizing Healthcare Quality/FOUNDATION
Service/Providing Solutions to Constituent Needs/ADVANCED
DESIRED SKILLS
Benefits Management/Understanding Clinical Impacts/FOUNDATION
General Business/Consulting for Solutions/ADVANCED
General Business/Turning Data into Information/FOUNDATION
ADDITIONAL JOB INFORMATION
Managed care experience a plus. - This position is in an office environment using a computer station and may require sitting for extended periods of time. - Candidate must possess good computer skills. - This is ideal for an applicant seeking a fast paced environment. . Full Time position, M-F, requiring 2 or 3 times a month a shift until 9:00pm. Will be located at 4050 Piedmont Parkway. No opportunity for work at home, so looking for someone who enjoys working in an office in a high energy and motivated team environment.
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.
We conduct pre-employment drug and background testing. Benefit eligibility may vary by position. Click here to review the benefits associated with this position.
Employment Type Regular Career Band Description Professional
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