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Case Manager RN - Gloucester/Camden County

Primary Location: Princeton, New Jersey
Additional Locations: NJ-Camden County, NJ-Gloucester County
The RN Case Manager is responsible for conducting face to face visits using comprehensive assessments of members enrolled in Managed Long-Term Services and Supports program (MLTSS).Develop, implement, support, and promote Health Services strategies, tactics, policies,and programs that drive the delivery of quality healthcare to establish competitive business advantage for Aetna. Health Services strategies, policies,and programs are comprised of utilization management, quality management, network management and clinical coverage and policies. Utilizes advanced clinical judgment and critical thinking skills to facilitate appropriate member physical health and behavioral healthcare through assessment and care planning, direct provider coordination/collaboration, and coordination of psychosocial wraparound services to promote effective utilization of available resources and optimal, cost-effective outcomes

Fundamental Components:
The care manager is responsible to coordinate and collaborate care with member/authorized representative, PCP, and any other careteam participant. The RN care manager will attend interdisciplinary meetingsand advocate on members behalf. The care manager works with member and careteam to develop care plan and will authorize services within the MLTSS benefit.The care manager will also work with the member and care team to coordinate andassist with community resources. The care manager is responsible for documenting accurately and timely in the electronic health record. This position requires the care manager to use critical thinking and be able toproblem solve any issues related to assigned membership. While this position istelework the care manager must work normal business hours

Background Experience:
3+years clinical practice experience, e.g., hospital setting, alternative caresetting such as home health or ambulatory care; Required
RN, (NJ Licensure required)
Experience with Assessments of Patients/Members through the use of clinical tools and information; Required
Case management and discharge planning experience; Preferred
Managed Care experience; Preferred
Crisis intervention skills; Preferred

Additional Job Information:
Telework potential after successful completion of training period in the Princeton office.

50-75% Field-based Travel Required to Meet With members

Potential Telework Position:

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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