Oncology Nurse Case ManagerPrimary Location: Blue Bell, PA
Additional Locations: CO-Denver, DE-Dover, GA-Atlanta, MO-Columbia, NC-Charlotte, PA-Blue Bell, TX-Fort Worth, WV-Charleston Apply
Full time telework opportunity open to candidates with 5+ years oncology experience. Candidates must have a compact RN license and be located 2 hours from an Aetna office in one of the following states: AZ, AR, CO, DE, FL, GA, ID, IA, KY, MD, MS, MN, MO, NM, NE, NC, ND, RI, SC, SD, TN, TX, UT, VA, WV, WI
This Registered Nurse Case Manager position is an exciting opportunity to join a growing Aetna Custom
Care Team located in our Blue Bell, PA office. You'll have the opportunity to work in an exciting, fast pace atmosphere and administer a high touch integrated model for various dedicated customers.
Through the use of clinical tools and information/data review, conducts an evaluation of member's needs and benefit plan eligibility and facilitates integrative functions as well as smooth transition to Aetna programs and plans. Applies clinical judgment to the incorporation of strategies designed to reduce risk factors and barriers and address complex health and social indicators which impact care planning and resolution of member issues.
Assessments take into account information from various sources to address all conditions including co-morbid and multiple diagnoses that impact functionality. Reviews prior claims to address potential impact on current case management and eligibility. Assessments include the member’s level of work capacity and related restrictions/limitations. Using a holistic approach assess the need for a referral to clinical resources for assistance in determining functionality. Consults with supervisor and others in overcoming barriers in meeting goals and objectives, presents cases at case conferences for multidisciplinary focus to benefit overall claim management.
Utilizes case management processes in compliance with regulatory and company policies and procedures. Utilizes interviewing skills to ensure maximum member engagement and discern their health status and health needs based on key questions and conversation.Background Experience:
5+ years clinical practice oncology experience
RN with current unrestricted state licensure required.
OCN certification preferred
Chemotherapy certifications preferred
Oncology Case Management in an integrated model preferred
Work requires the ability to perform close inspection of hand written and computer generated documents as well as a PC monitor.
Sedentary work involving periods of sitting, talking, listening. Work requires sitting for extended periods, talking on the telephone and typing on the computer.
Ability to multitask, prioritize and effectively adapt to a fast paced changing environment
Position requires proficiency with computer skills which includes navigating multiple systems and keyboarding
Effective communication skills, both verbal and written. Required Skills: Benefits Management - Understanding Clinical Impacts, General Business - Applying Reasoned Judgment, Service - Providing Solutions to Constituent Needs Desired Skills: Benefits Management - Maximizing Healthcare Quality, Benefits Management - Supporting Medical Practice, Finance - Managing Aetnas Risk Functional Skills: Nursing - Case Management, Nursing - Discharge Planning, Nursing - Disease management, Nursing - Oncology Technology Experience: Desktop Tool - Microsoft Explorer, Desktop Tool - Microsoft Outlook, Desktop Tool - Microsoft Word Education: Nursing - Certified Case Manager (CCM), Nursing - Registered Nurse Potential Telework Position: Yes Percent of Travel Required: 0 - 10% EEO Statement: Aetna is an Equal Opportunity, Affirmative Action Employer Benefit Eligibility: Benefit eligibility may vary by position. Click here to review the benefits associated with this 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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