Care PlannerPrimary Location: Sandy City, Utah
Additional Locations: FL-Boynton Beach, MO-Chesterfield, SC-Columbia, UT-Sandy Apply
Full time telework opportunity open to candidates across the country. Hours are 8:30-5pm MST.
Provide support and service to behavioral health clinical teams in support of member engagement and care.
Collects data from designated administrative sources and reviews findings in order to identify potential enrollees for clinical specialty programs. Provides outreach to members to educate them about available specialty programs and to solicit their participation. Administers structured pre-screening questionaire in order to provide relevant member information to care manager so that clinical assessment process can be faciliated by care manager. Administers appropriate structured functional assessments and out come tools including but not limited to SF12, CAGE, PHQ9, WLQ. Educates members about available web-based resources. Under direction of clinical management staff and supported by care associates, conducts case management related research and coordinates both internal and external resources, assisting members with claim and benefit issue resolution, referrals to EAP, referrals to legal and financial services and referrals to community support services. Serves as primary behavioral health point of contact for member.
Supports the development and implementation of behaviorial health treatment plans, functioning as an integral member of the care management team. Participates in designated team meetings and case rounds with other clinical and medical staff. Adheres to compliance and Patient Management policies and regulatory requirements. Maintains accurate and complete documentation of required information meeting risk management, regulatiory and accrediation requirements. Participates in designated clinical quality management initiatives. Exhibits behaviors outlined in Employee Competencies.Background Experience:
Minimum of 2+ years behavioral health care experience required
Required Skills: Service - Case Administration, Service - Demonstrating Service Discipline, Service - Improving Constituent-Focused Processes Desired Skills: Benefits Management - Maximizing Healthcare Quality, General Business - Communicating for Impact, General Business - Turning Data into Information Functional Skills: Administration / Operation - Data Entry, Clinical / Medical - General Management, Communication - Member communications Technology Experience: Aetna Application - Aetna Behavioral Health, Aetna Application - Aetna Total clinical View Potential Telework Position: Yes 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
Associates Degree, Bachelors Degree in Psychology or Social Services preferred or equivalent work experience.
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