Case Management CoordinatorPrimary Location: Orlando, Florida
Additional Locations: FL-Casselberry, FL-Longwood, FL-Orlando Apply
Work From Home Position residing in Orange or Seminole County, Orlando, FL area.
Schedule Monday-Friday standard business hours. No nights, no weekends and no holidays!
- Conducts comprehensive evaluation of Members using care management tools and information/data review
- Coordinates and implements assigned care plan activities and monitors care plan progress
- Conducts multidisciplinary review in order to achieve optimal outcomes
- Identifies and escalates quality of care issues through established channels
- Utilizes negotiation skills to secure appropriate options and services necessary to meet the member’s benefits and/or healthcare needs
- Utilizes influencing/ motivational interviewing skills to ensure maximum member engagement and promote lifestyle/behavior changes to achieve optimum level of health
- Provides coaching, information and support to empower the member to make ongoing independent medical and/or healthy lifestyle choices
- Helps member actively and knowledgably participate with their provider in healthcare decision-making
- Monitoring, Evaluation and Documentation of Care: Utilizes case management and quality management processes in compliance with regulatory and accreditation guidelines and company policies and procedures.
Experience conducting home visits required
Long Term Care or home healthcare experience preferred
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 and work with minimum supervision. The position comes with an excellent benefit package, paid time off, mileage reimbursement
Desired Skills: Benefits Management - Understanding Clinical Impacts, General Business - Applying Reasoned Judgment, Service - Case Administration, Service - Handling Service Challenges Potential Telework Position: Yes 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
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