RN - Case Manager - Registered Nurse
Less than 5 years experience • Managed Care & Health Insurance
RN - Case Manager- Registered Nurse
This Case Manager role works telephonically with members who have medical, commercial insurance coverage through an employer-based health plan. Through the process of assessment, planning, and advocacy the case manager will help the member achieve their highest level of health in the most appropriate and cost-effective setting. Ideal candidates will have general medical/surgical experience, or experience in specialty areas such as Oncology, Orthopedics, Intensive Care, Emergency Department or Home Health.
All member/provider contact is by phone or electronic media with an expectation that timeliness standards are met. An example of a member you might work with as an Aetna Case Manager, would be someone who has just had an acute hospitalization and need assistance such as home healthcare, equipment or office visits. They may also have educational needs surrounding their hospital stay, such as pain control, wound self-management, medication adherence or managing their chronic conditions. This is where our Case Managers becomes a much needed resource and advocate for members who have left the acute setting and are now challenged with recovering and getting back to their previous level of functioning and achieving their ultimate level of health.
This position is in an office environment using a computer station and may require sitting for extended periods of time. - Candidate must possess computer and typing skills. - This is ideal for an applicant seeking a fast paced environment. Full Time position, M-F, requiring 2 or 3 times a month a shift until 9:00pm (self-scheduled). Will be located at 4050 Piedmont Parkway. Work from home opportunities may be available after 12-18 months of employment, determined by business need. Looking for someone who enjoys working in an office in a high energy and motivated team environment.
The Case Manager is responsible for telephonically assessing, planning, implementing and coordinating all case management activities with members to evaluate the medical needs, overall wellness and/or appropriate and timely return to work.
The case manager develops a proactive course of action to enhance short and long term outcomes as well as identifying opportunities to enhance a members overall wellness through integration with partner programs.
- Current, unrestricted RN license
- Minimum of 3 years diverse clinical background
- Case Management and/or Managed Care experience a plus
- Strong technical and computer skills are a must including MS Office!
The highest level of education desired for candidates in this position is a Bachelor's degree or equivalent experience.
LICENSES AND CERTIFICATIONS
Nursing/Registered Nurse (RN)
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