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Case Management Coordinator North Orlando, FL

Primary Location: Orlando, FL
Additional Locations: FL-Orlando
Utilizes critical thinking and judgment to collaborate and inform the case management process, in order to facilitate appropriate healthcare outcomes for members by providing care coordination, support and education for members through the use of care management tools and resources.

Work From Home Position residing in Orange or Seminole County, North Orlando, FL area.

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

Fundamental Components:
  1. Conducts comprehensive evaluation of Members using care management tools and information/data review
  2. Coordinates and implements assigned care plan activities and monitors care plan progress
  3. Conducts multidisciplinary review in order to achieve optimal outcomes
  4. Identifies and escalates quality of care issues through established channels
  5. Utilizes negotiation skills to secure appropriate options and services necessary to meet the member’s benefits and/or healthcare needs
  6. Utilizes influencing/ motivational interviewing skills to ensure maximum member engagement and promote lifestyle/behavior changes to achieve optimum level of health
  7. Provides coaching, information and support to empower the member to make ongoing independent medical and/or healthy lifestyle choices
  8. Helps member actively and knowledgably participate with their provider in healthcare decision-making

Background Experience:
  • Experienced and certified in DOEA 701B comprehensive assessment
  • Experience conducting home visits required
  • Long Term Care or home healthcare experience required
  • Case management and discharge planning experience preferred
  • 2 years experience in behavioral health, social services, social work or appropriate related field equivalent to program focus
  • Bi-lingual preferred (Spanish/ English)
  • Understanding Medicare/Medicaid benefits preferred
  • Managed Care experience preferred
  • Candidate must have at least intermediate computer data entry working experience, excel, word

Additional Job Information:
This position requires Candidate to be able to multitask, understand and follow state program guidelines, and work with minimum supervision. The position comes with an excellent benefit package, paid time off, mileage reimbursement

Desired Skills:
Benefits Management - Maximizing Healthcare Quality, Benefits Management - Understanding Clinical Impacts, Service - Providing Solutions to Constituent Needs

Potential Telework Position:

Percent of Travel Required:
25 - 50%

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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