At Aetna, we’re pioneering a total approach to health and wellness, focusing on the whole person - body, mind, and spirit. Our more than 4,000 nurses are central to turning our member’s health ambitions, big and small, into achievements. Your role will include helping members stay well, manage health conditions, and access the right care at the right time. As you do this, we’ll support you in achieving more in your life and your work.
What makes a successful nurse? Here are the traits we are looking for:
- Problem Solver
- Results Driven
- Technology Savvy
- Detail Oriented
- Good Listener
- Open Minded
- Team Player
Paid Time Off & Disability
Field Case Manager (RN)Primary Location: Charleston, West Virginia
Additional Locations: WV-Charleston Apply
Candidates must live in or near one of the following counties in WV: Kanawha, Putnam, Cabell, Boone, Raleigh, Fayette, Marion, Mongolia, Brooke, Hancock, or Ohio counties.
We are building an exciting new clinical and member experience program at Aetna. Aetna Case Management is a member centric, team-delivered, community based care management model that joins members where they are. The Field Case Manager works collaboratively with an interdisciplinary team in the process of assessment, planning, facilitation, care coordination, evaluation, and advocacy. The Field Case Manager connects members to the resources and services, available in their own community, to support the members comprehensive health needs while promoting quality care and cost effective outcomes.
Responsible for case management of eligible Aetna members with complex care needs; partners with an interdisciplinary team to deliver comprehensive, community-based case management services focused on helping the member maximize best health outcomes. Interacts with members in-person, in their home on a regular basis; also meets members at an agreed upon community location such as a library. Interacts with members telephonically following at least the minimum standard of contact required per member based on their level of intervention. Conducts in-person, individualized assessments to identify problems, goals, & interventions with corresponding measurable outcomes that drive the content of the holistic, member centered care plan.
Develops a healthy action plan in partnership with the member, defining problems, goals, and objectives to improve the members overall wellbeing/quality of life, continuously partners with the member to evaluate the members progress in setting/meeting the established goals, and revising/updating the health action plan accordingly. Utilizes influencing and motivational interviewing skills to ensure maximum member engagement; promotes lifestyle and behavior changes to achieve optimum level of health.
Helps members actively and knowledgeably participate with providers in healthcare decision-making; helps members actively and knowledgeably participate with community based organizations able to support in meeting health goals. Conducts assessments for members discharged from an in-patient hospital or skilled nursing facility, supports post discharge plan of care for both members assigned within their case load and members outside of the case load but residing within their local community.
RN licensure required
5+ years clinical experience required
Ability to travel within a designated geographic area for in-person case management activities
Case management experience highly preferred
Home health/ hospice experience highly preferred
Managed care experience preferred
Excellent analytical and problem solving skills
Effective communications, organizational, and interpersonal skills
Proficiency with standard corporate software applications, including MS Word, Excel, Outlook and PowerPoint, as well as some special proprietary applications
Effective computer skills including navigating multiple systems and keyboarding.
The minimum level of education required for candidates in this position is a Associate's degree or equivalent experience.
LICENSES AND CERTIFICATIONS
Nursing/Board of Nursing (Any State) is required
Nursing/CMSA Case Management Society of America is desired
Functional - Nursing/Case Management/1+ Years
Functional - Nursing/Discharge Planning/4+ Years
Functional - Nursing/Home Health Care Ambulatory Nursing/1+ Years
Technical - Desktop Tools/Microsoft Outlook/1+ Years/End User
Technical - Remote Access/WAH (Work at Home)/1+ Years/End User
ADDITIONAL JOB INFORMATION
This is an exceptional opportunity for case management of Medicare members, in collaboration with MDT- Nurse Case Manager, Medical Director, Social Worker, Pharmacist, Behavioral Health to develop creative case plans with traditional and non-traditional resources. There are available educational opportunities to meet both personal and professional goals. We have a culture of value-driven team.
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.
Benefit eligibility may vary by position. Click here to review the benefits associated with this position.
Aetna takes our candidates'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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