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A new day in healthcare. Together, CVS Health and Aetna help people on their path to better health.

Case Management Coordinator

Primary Location: Tampa, Florida
Additional Locations: FL-Tampa
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Description:
Utilizes critical thinking and judgment to collaborate and inform the case management process, in order to facilitate appropriate healthcare outcomes for members by providing care coordination, support and education for members through the use of care
management tools and resources.


Fundamental Components:

- Conducts comprehensive evaluation of Members using care
management tools and information/data review





- Coordinates and implements assigned care plan activities
and monitors care plan progress





- Identifies and escalates quality of care issues through
established channels





- Utilizes negotiation skills to secure appropriate options
and services necessary to meet the member’s benefits and/or healthcare needs





- Utilizes influencing/ motivational interviewing skills to
ensure maximum member engagement and promote lifestyle/behavior changes to
achieve optimum level of health





- Provides coaching, information and support to empower the
member to make ongoing independent medical and/or healthy lifestyle choices





- Helps member actively and knowledgably participate with
their provider in healthcare decision-making





Monitoring, Evaluation and Documentation of Care: Utilizes
case management and quality management processes in compliance with regulatory
and accreditation guidelines and company policies and procedures.



Background Experience:

Case management and discharge planning experience preferred
2 years experience in behavioral health, social services or appropriate related field equivalent to program focus
Managed Care or Long Term Care experience preferred
Bachelor's degree or non-licensed master level clinician required, with either degree being in behavioral health or human services preferred (psychology, social work, marriage and family therapy, counseling).


Bi-lingual preferred (Spanish/ English)



Candidate must have computer data entry knowledge, excel,
word














Additional Job Information:
Case Manager will be responsible for effectively managing a caseload between 50 - 100 Long Term Care members within the region.This includes completing comprehensive assessments, developing person centered care plans and implementing services designed to support the Member in the home setting, Assisted Living Facilities and Nursing Homes. Must adhere to Agency for Healthcare Administration and Aetna Better Health of Florida Comprehensive plan contract requirements. Able to work independently and manage time effectively.

Required Skills:
Service - Case Administration, General Business - Communicating for Impact, General Business - Applying Reasoned Judgment

Desired Skills:
Benefits Management - Encouraging Wellness and Prevention, Benefits Management - Interacting with Medical Professionals

Potential Telework Position:
Yes

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

Click To Review Our Benefits (PDF)

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