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
A1A Case Manager (RN) - $5,000 Sign-On BonusPrimary Location: High Point, North Carolina
Additional Locations: NC-High Point Apply
An 8 hour shift Monday-Friday between the hours of 8am-11pm EST required.
New hires are eligible for a one-time sign-on bonus of $5,000.
A1A (Aetna One Advocate) is a fully integrated population health and customer service solution for large plan sponsors. Our embedded and customer-dedicated service, clinical, and rising risk pods allow maximization of inbound and outbound touchpoints to solve members’ needs and create behavior change. Our white-glove service and end-to-end ownership of member support creates a trusted partner in health. We are the premiere service and clinical offering for Aetna nation-wide and create industry-leading solutions for our customers and members.
The Clinical Services Advocate is part of a dedicated team of clinical and service professionals empowered to take care of all aspects of a member’s health. Clinical Services Advocates are responsible for providing personalized, end to end member support including coordination of health care services, decision support, benefits support, complex case management and chronic condition management. Clinical Service Advocates serve as a single point of contact to help the member and family maximize benefits and easily navigate the health care system. The Clinical Advocate provides the member with a powerful and proactive experience through high touch, personalized communications designed to help the member achieve their health ambition.
65574Fundamental Components: 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.
Typical office working environment with productivity and quality expectations. 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.
Background Experience: -RN with current unrestricted state licensure required
-3+ years clinical practice experience required
-Case Management in an integrated model preferred
Additional Job Information: Typical office working environment with productivity and quality expectationsWork 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 environmentPosition requires proficiency with computer skills which includes navigating multiple systems and keyboardingEffective communication skills, both verbal and written. Required Skills: General Business - Communicating for Impact, Leadership - Collaborating for Results Desired Skills: Benefits Management - Encouraging Wellness and Prevention, General Business - Demonstrating Business and Industry Acumen Functional Skills: Nursing - Case Management, Nursing - Concurrent Review/discharge planning Technology Experience: Desktop Tool - Microsoft Outlook, Desktop Tool - Microsoft Word Education: Nursing - Registered Nurse (RN) Potential Telework Position: No 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.
Health hero Q&A
This Aetna nurse helps new moms overcome opioids.
2018 Most Admired
Aetna named one of Fortune's most admired companies
Sign up for Job Alerts
Explore This Area
Check out where you could be working if you apply.View Map
- Assistant Finance Admin (Contract role), Hong Kong
- Utilization Management Nurse Consultant Bethlehem, Pennsylvania
- Member Services Representative San Diego, California
Join Our Talent Community
Sign up to receive information about job openings that are tailored to your skills and interests. Plus, get the latest career news from Aetna.