Case Manager RNPrimary Location: Bethlehem, PA
Additional Locations: OH-Richfield, PA-Bethlehem Apply
Nurse Case Manager utilizes advanced clinical judgment and critical thinking skills to facilitate appropriate physical and behavioral healthcare and social services for members through assessment and member-centered care planning, direct provider coordination/collaboration, and coordination of psychosocial wraparound services to promote effective utilization of available resources, optimal member functioning, and cost-effective outcomes
64001Fundamental Components: The ideal candidate is a Registered Nurse with an unrestrictive license and minimum 3-5 years clinical experience. The candidate has the ability to exercise independent and sound judgment, has strong decision-making skills and well-developed interpersonal skills. Ability to manage multiple priorities, effective organizational and time management skills along with strong teamwork skills. Managed Care experience and prior experience within a telephonic customer service center type of environment is preferred. Candidate must possess good computer skills. Fundamental components related to the Care Management Unit include but are not limited to; Utilizes assessment techniques to determine member’s level of health literacy, technology capabilities, and/or readiness to change. Utilizes influencing/motivational interviewing skills to ensure maximum member engagement and promote lifestyle/behavior changes to achieve optimum level of health. Provides coaching, information, education and support to empower the member to make ongoing independent medical and/or healthy lifestyle choices. Background Experience: RN licensure required
3+ years clinical experience required
Case management experience preferred
Managed care experience preferred
Additional Job Information: Typical office working environment with productivity and quality expectationsWork requires the ability to perform close inspection of hand written and computer generated documents as well as a PC monitor.Sedentary work involving periods of sitting, talking, listening. Work requires sitting for extended periods, talking on the telephone and typing on the computer.Ability to multitask, prioritize and effectively adapt to a fast paced changing environmentPosition requires proficiency with computer skills which includes navigating multiple systems and keyboardingEffective communication skills, both verbal and written. Required Skills: Benefits Management - Maximizing Healthcare Quality, Benefits Management - Supporting Medical Practice, Benefits Management - Understanding Clinical Impacts Functional Skills: Nursing - Case Management, Nursing - Discharge Planning, Nursing - Medical-Surgical Care Technology Experience: Desktop Tool - Microsoft Explorer, Desktop Tool - Microsoft Outlook, Desktop Tool - Microsoft Word Education: Nursing - Registered Nurse (RN) 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 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.
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