At Aetna, we’re pioneering a total approach to health and wellness, focusing on the whole person - body, mind, and spirit. Our more than 4,000 nurses are central to turning our member’s health ambitions, big and small, into achievements. Your role will include helping members stay well, manage health conditions, and access the right care at the right time. As you do this, we’ll support you in achieving more in your life and your work.
What makes a successful nurse? Here are the traits we are looking for:
- Problem Solver
- Results Driven
- Technology Savvy
- Detail Oriented
- Good Listener
- Open Minded
- Team Player
Paid Time Off & Disability
Workers Compensation RN Field Case Manager Registered Nurse Monroe, MIPrimary Location: Toledo, Ohio
Additional Locations: MI-Detroit Apply
Responsible for coordinating and facilitating the medical treatment of clients. Clients are primarily from workers comp claims in various stages of recovery. This is a work-from-home position, and the case manager will travel to meet and work with clients, providers and employers, as needed, throughout the rehabilitation process, documenting all activities.
Coventry provides all necessary tools and training materials for the case management staff to facilitate the case management process and establish case management plans on all files. Each Case Manager participates in core training as part of their initial orientation and additional training is provided annually and as necessary. Bonus payout on monthly basis for hours billed above monthly expectation. Work schedule is general business hours Monday thru Friday with some flexibility to schedule appointments. All case management is no-touch, no direct care of any kind is provided to the client.
Aetna is about more than just doing a job. This is our opportunity to re-shape healthcare for America and across the globe. We are developing solutions to improve the quality and affordability of healthcare. What we do will benefit generations to come. We care about each other, our customers and our communities. We are inspired to make a difference, and we are committed to integrity and excellence. Together we will empower people to live healthier lives.
Aetna is an equal opportunity & affirmative action employer. All qualified applicants will receive consideration for employment regardless of personal characteristics or status. We take affirmative action to recruit, select and develop women, people of color, veterans and individuals with disabilities.
We are a company built on excellence. We have a culture that values growth, achievement and diversity and a workplace where your voice can be heard.
58404Fundamental Components: Fundamental Components but not limited to the following:
Requires strong time management skills, ability to multi-task, prioritize tasks and respond to issues in a timely manner. Requires competent use of technology including iPhones, laptops, and Microsoft Office programs including email to complete timely, concise and effective communication the status of the clients.
Manage caseload of clients from a variety of referral sources including verifying the specific reason for each referral, develop and implement a strategy to complete, and document all activities and progress.
Travel to meet clients, providers and employers mostly around the Monroe MI & Toledo Ohio area, up to approximately 75 miles from this area. Must use own car and mileage reimbursement is provided.
Will meet clients to complete assessments, identify medical and vocational barriers, and create strategies towards facilitating the rehab process, including return to work for workers comp clients. Will continually identify barriers and develop strategies to overcome those barriers.
Attend appointments with clients and providers to review medical status and discuss treatment plans options. Compare the recommended treatment plan with clinical protocols and collaborate with the provider to resolve any differences. Will review plan with client and provide educational resources on relevant medical issues.
With workers comp referrals, will meet with employers as needed to determine what is needed for the client to return to work, includes documenting all the physical requirements of the job (Job Analysis) and reviewing the requirements with the providers. Will maintain regular communication with the employer to facilitate return to work.
Detailed information on any significant information is provided to the referral source within 24 hours with summary reports completed on a monthly basis.
Required to complete catastrophic referral training within the first year and manage the occasional catastrophic referrals that are after regular business hours.
Coventry requires Case Managers to be educated in current principles, procedures and knowledge domains of case management based on nationally recognized standards of case management. Background Experience: BACKGROUND/EXPERIENCE:
3+ years clinical practice experience.
3+ years case management experience with workers compensation, disability, and auto liability preferred.
If no case management experience, 5 years of Home Health Care and/or Hospice care.
Bilingual in Spanish preferred.
Knowledge of laws and regulations governing delivery of rehabilitation services.
Effective communications, organizational, and interpersonal skills.
Ability to work-independently, requires working from home in a safe and secure environment.
Proficiency with standard corporate software applications, including MS Word, Excel, Outlook and PowerPoint, as well as some special proprietary applications.
Effective computer skills including navigating multiple systems and keyboarding
The minimum level of education desired for candidates in this position is a Bachelor's degree or equivalent experience.
LICENSES AND CERTIFICATIONS
Nursing/Registered Nurse (RN) is required
Functional - Nursing/Case Management/1-3 Years
Functional - Nursing/Home Health Care/4-6 Years
Functional - Nursing/Occupational/1-3 Years
Functional - Nursing/Medical-Surgical Care/4-6 Years
Technical - Desktop Tools/Microsoft Outlook/4-6 Years/End User
Technical - Desktop Tools/Microsoft Word/4-6 Years/End User
Technical - Desktop Tools/Microsoft Explorer/4-6 Years/End User
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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