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Behavioral Health Care Planner

Primary Location: Blue Bell, PA
Additional Locations: PA-Blue Bell
Provide support and service to behavioral health clinical teams in support of member engagement and care.

Schedule is standard business hours Monday-Friday. No nights, no weekends and no holidays!

Fundamental Components:
Collects data from designated administrative sources and reviews findings in order to identify potential enrollees for clinical specialty programs. Provides outreach to members to educate them about available specialty programs and to solicit their participation. Administers structured pre-screening questionaire in order to provide relevant member information to care manager so that clinical assessment process can be faciliated by care manager. Administers appropriate structured functional assessments and out come tools including but not limited to SF12, CAGE, PHQ9, WLQ. Educates members about available web-based resources. Under direction of clinical management staff and supported by care associates, conducts case management related research and coordinates both internal and external resources, assisting members with claim and benefit issue resolution, referrals to EAP, referrals to legal and financial services and referrals to community support services. Serves as primary behavioral health point of contact for member. Supports the development and implementation of behaviorial health treatment plans, functioning as an integral member of the care management team. Participates in designated team meetings and case rounds with other clinical and medical staff. Adheres to compliance and Patient Management policies and regulatory requirements. Maintains accurate and complete documentation of required information meeting risk management, regulatiory and accrediation requirements. Participates in designated clinical quality management initiatives. Exhibits behaviors outlined in Employee Competencies.

Background Experience:
Minimum of 2 years behavioral health care experience.

Associates Degree, Bachelors Degree in Psychology or Social Services preferred or equivalent work experience.

Required Skills:
Service - Case Administration, Service - Providing Solutions to Constituent Needs

Desired Skills:
Service - Improving Constituent-Focused Processes, Technology - Leveraging Technology

Functional Skills:
Clinical / Medical - Disease management

Technology Experience:
Aetna Application - Aetna Total clinical View, Desktop Tool - Microsoft Outlook, Desktop Tool - Microsoft Word

Potential Telework Position:

Percent of Travel Required:
0 - 10%

EEO Statement:
Aetna is an Equal Opportunity, Affirmative Action Employer

Benefit Eligibility:
Benefit eligibility may vary by position.

Candidate Privacy Information:
Aetna takes our candidate's data privacy seriously. At no time will any Aetna recruiter or employee request any financial or personal information (Social Security Number, Credit card information for direct deposit, etc.) from you via e-mail. Any requests for information will be discussed prior and will be conducted through a secure website provided by the recruiter. Should you be asked for such information, please notify us immediately.


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