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Care Coordinator

Primary Location: Pennsylvania
Additional Locations: PA-Moon township
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Description:
Coordinates medical care for infant, child, or elderly member population to ensure appropriate medical care is provided. Responsible for contacting members, parents and/or guardians, Primary Care Providers (PCPs), skilled nursing facilities, and/or other care team members regarding coordination of medical care. Ensures compliance with all State and Federal regulations and accrediting bodies.

Fundamental Components:
Facilitates steps to ensure all newborns and children of Medicaid families receive routine services including check-ups and immunizations, as necessary; assists parents in scheduling PCP appointments; follows-up to ensure appointments are honored. Monitors the application process for all newborns and children, as necessary; ensures all necessary paperwork is submitted to the appropriate agency, and that each member is accurately enrolled and assigned to the correct plan. Assists with the placement of adult members being discharged from an acute inpatient facility to a sub-acute hospital, skilled nursing facility, or acute rehabilitation facility; works in conjunction with the clinical staff, physicians, and facilities to determine appropriate placement; serves as liaison between the facilities, providers, and staff. Serves as liaison between facilities and vendors to ensure that proper equipment and other health care needs are met; assists with discharge planning needs as appropriate. Participates in State directed meetings and/or services to provide care and coordination of care for the pediatric Medicaid population. Performs other related duties as required.

Background Experience:
Experience with Microsoft Office products (Word, Excel, Project, PowerPoint, Outlook).Minimum of 1 year recent and related experience in managed care and direct customer service preferred, but not required. High School Diploma or G.E.D.

Additional Job Information:



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

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