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Aetna is now a CVS Health Company

Case Manager RN

Primary Location: San Antonio, TX
Additional Locations: TX-San Antonio
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Description:
Office-based position in San Antonio, TX.

The Case Manager utilizes a collaborative process of assessment, planning, facilitation and advocacy for options and services to meet an individual's benefit plan and/or health needs through communication and available resources to promote optimal, cost-effective outcomes. Requires an RN with unrestricted active license. The hours for this position are 8am-6pm CT, Mon-Fri, with some flexibility.


Fundamental Components:
The Nurse Case Manager, utilizing advanced clinical judgment and critical thinking skills, is responsible for telephonically assessing, planning, implementing and coordinating all case management activities with members to evaluate appropriate physical and behavioral healthcare and social services for the member. Through assessment and member-centered care planning, direct provider coordination/collaboration, and coordination of psychosocial services, the Case Manager promotes effective utilization of available resources, optimal member functioning, and cost-effective outcomes. In doing this, the Case Manager develops a proactive course of action to address issues to enhance the short and long term outcomes as well as opportunities to enhance a members overall wellness through integration.

Background Experience:
RN licensure required
5+ years clinical experience required

Case management experience preferred
Managed care experience preferred


Additional Job Information:
Typical office working environment with productivity and quality expectations Work 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 environment Position requires proficiency with computer skills which includes navigating multiple systems and keyboarding Effective communication skills, both verbal and written.

Required Skills:
Benefits Management - Maximizing Healthcare Quality, Benefits Management - Understanding Clinical Impacts, Leadership - Collaborating for Results

Desired Skills:
General Business - Applying Reasoned Judgment, Leadership - Driving a Culture of Compliance, Technology - Leveraging Technology

Functional Skills:
Nursing - Case Management, Nursing - Discharge Planning, Nursing - Medical-Surgical Care

Technology Experience:
Aetna Application - Aetna Strategic Data Warehouse, Aetna Application - Aetna Total clinical View, Desktop Tool - Microsoft Outlook, Desktop Tool - Microsoft Word

Education:
Nursing - Certified Case Manager (CCM), 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.

Click To Review Our Benefits (PDF)

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