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Workers Compensation RN Field Case Manager Spanish

Primary Location: Newark, DE
Additional Locations: DE-Newark
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Description:
JOIN OUR GROWING TEAM
Are you tired of bedside nursing?
Are you looking to get away from 12-hour hospital shifts while continuing to utilize your RN expertise to impact the lives of patients in your local community?

We are seeking self-motivated, energetic, detail oriented, highly organized, tech-savvy Registered Nurses to join our Workers’ Compensation Field Case Management team. This opportunity offers a competitive salary, full benefits, and a performance-based bonus paid out on a monthly or quarterly basis. Our organization promotes autonomy through a Monday-Friday working schedule, paid holidays, and flexibility as you coordinate the care of your members.

TERRITORY: DELAWARE, AND WEST CHESTER, MALVERN, PAOLI, KING OF PRUSSIA, RIDLEY PARK, PHILADELPHIA OF PENNSYLVANIA.

The Case Manager uses a collaborative process of assessment, planning, facilitation, care coordination, evaluation, and advocacy for options and services to meet an individual’s and family’s comprehensive health needs through communication and available resources to promote quality, cost effective outcomes.

Fundamental Components:
Acts as a liaison with member/client /family, employer, provider(s), insurance companies, and healthcare personnel as appropriate. Implements and coordinates all case management activities relating to catastrophic cases and chronically ill members/clients across the continuum of care that can include consultant referrals, home care visits, the use of community resources, and alternative levels of care. Interacts with members/clients telephonically or in person. May be required to meet with members/clients in their homes, work-sites, or physician’s office to provide ongoing case management services. Assesses and analyzes injured, acute, or chronically ill members/clients medical and/or vocational status; develops a plan of care to facilitate the member/client’s appropriate condition management to optimize wellness and medical outcomes, aid timely return to work or optimal functioning, and determination of eligibility for benefits as appropriate. Communicates with member/client and other stakeholders as appropriate (e.g., medical providers, attorneys, employers and insurance carriers) telephonically or in person. Prepares all required documentation of case work activities as appropriate. Interacts and consults with internal multidisciplinary team as indicated to help member/client maximize best health outcomes. May make outreach to treating physician or specialists concerning course of care and treatment as appropriate. Provides educational and prevention information for best medical outcomes. Applies all laws and regulations that apply to the provision of rehabilitation services; applies all special instructions required by individual insurance carriers and referral sources. Testifies as required to substantiate any relevant case work or reports. Conducts an evaluation of members/clients’ needs and benefit plan eligibility and facilitates integrative functions using clinical tools and information/data. Utilizes case management processes in compliance with regulatory and company policies and procedures. Facilitates appropriate condition management, optimize overall wellness and medical outcomes, appropriate and timely return to baseline, and optimal function or return to work. Develops a proactive course of action to address issues presented to enhance the short and long-term outcomes, as well as opportunities to enhance a member’s/client’s overall wellness through integration. Monitors member/client progress toward desired outcomes through assessment and evaluation.

All employees are expected to embody our values of Excellence, Integrity, Caring and Inspiration in all that they do as an employee. The overall responsibility of the Field Case Manager is to ensure the injured worker receives the best possible care in a timely and efficient manner towards full rehabilitation and return to work. Please note that we do offer mileage reimbursement for local travel.
As a Workers’ Compensation Field Case Manager, you will be offered:
Autonomy
Productivity incentives
Monday-Friday schedule
Reimbursement for mileage, tolls, parking, licensure and certification
Laptop, iPhone & printer/fax/scanner all in one.
All major holidays are paid time off, vacation and sick time off is accrued. Full benefits offered including 401(k) and many corporate discounts available. Employees are reimbursed for fees to maintain licensure as well as free CEU’s to maintain licensure. Continuing Education credits are available/provided for RN and a various industry certifications too. Work from home with in-state travel. In addition to annual salary, position has potential for a monthly monetary bonus.

Benefit eligibility may vary by position. Click here to review the benefits associated with this position.


Background Experience:
Ability to travel within a designated geographic area around Wilmington, DE and Philadelphia, PA and surrounding counties, for in-person case management activities.
3 years clinical practice experience (required for NCM role only).
3 years case management experience (required for NCM role, preferred for all other areas) preferred.
Effective computer skills including navigating multiple systems and keyboarding
Job-specific technical knowledge, (e.g., knowledge of workers compensation and disability industry for workers’ compensation case managers or case management).
Excellent analytical and problem solving skills
Bilingual Spanish preferred
Proficiency with standard corporate software applications, including MS Word, Excel, Outlook and PowerPoint, as well as some special proprietary applications.
Ability to work independently.
Knowledge of laws and regulations governing delivery of rehabilitation services in the state of Delaware
Effective communications, organizational, and interpersonal skills.

CERTIFICATION
Additional national professional certification (CRC, CDMS, CRRN, COHN, or CCM) is preferred, but not required.
Certified Case Manager is preferred.


LICENSE required
Must be a Registered Nurse with active DE or PA license in good standing.

Additional Job Information:
The case manager day is different from day to day. The case manager will arrange, confirm and attend office visits with injured workers, will coordinate care and arrange therapy, diagnostic testing and other medical needs. Will collaborate with employer to coordinate return to work based on current work restrictions given by physician. Will maintain contact and provide timely updates to all parties involved and ensure that forward progress is being made with recovery with a goal to return to work. Will complete required documentation and reports timely.

Required Skills:
Benefits Management - Interacting with Medical Professionals, General Business - Applying Reasoned Judgment, Service - Handling Service Challenges

Desired Skills:
General Business - Communicating for Impact, General Business - Maximizing Work Practices, Service - Working Across Boundaries

Functional Skills:
Clinical / Medical - Concurrent review / discharge planning, Clinical / Medical - Disease management, Medical Management - Medical Management - Case Management, Medical Management - Medical Management - Workers compensation

Technology Experience:
Desktop Tool - Microsoft Outlook, Desktop Tool - Microsoft Word

Education:
Nursing - Certified Case Manager, Nursing - Certified Case Manager (CCM), Nursing - Registered Nurse, Nursing - Registered Nurse (RN)

Potential Telework Position:
Yes

Percent of Travel Required:
50 - 75%

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.

Click To Review Our Benefits (PDF)

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