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in High Point, NC

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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. All member/provider contact is by phone or electronic media with an expectation that timeliness standards are met.

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. This is an exciting Full Time position, M-F. Will be located at 4050 Piedmont Parkway. No opportunity for work at home for new employees, looking for someone who enjoys working in an office in a high energy and motivated team environment! Current employees that are telework position can remain as teleworker if selected.

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.

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 (Hospital or home health preferred)

- 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

Telework Specifications:

New Employees will work out of the High Point , NC office.

Current internal teleworkers will work from home if selected for position.

ADDITIONAL JOB INFORMATION

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