Case Manager RNPrimary Location: Tampa, Florida
Additional Locations: FL-Tampa Apply
59503Fundamental Components: Through the use of clinical and psychosocial tools and information/data review, conducts an evaluation of member's needs and implements care plan services aimed at keeping the Member in the least restrictive setting. Applies clinical judgment to the incorporation of strategies designed to reduce risk factors and barriers and address complex health and social indicators which impact care planning and resolution of member issues. Assessments take into account information from various sources including formal and informal supports and social determinants of health to address all conditions including co-morbid and multiple diagnoses that impact functionality. Consults with supervisor, utilization management and others in overcoming barriers in meeting goals and objectives, presents cases at case conferences for multidisciplinary focus to benefit overall program management. Utilizes case management processes in compliance with regulatory and company policies and procedures. Utilizes interviewing skills to ensure maximum member engagement and discern their health status and health needs based on key questions and conversation. Background Experience: Case Management in an integrated model preferred
Managed Care experience preferred
5 years clinical practice experience
RN with current unrestricted state licensure required. Additional Job Information:
Full-Time Telework (WAH) with office support location in
Tampa - 3611 Queen Palm Drive. Required in-office training. Travel within the region including Polk, Hardee, Highland, Manatee, and Hillsborough Counties.
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. Functional Skills: Clinical / Medical - Disease management Education: Nursing - Registered Nurse (RN) 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
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