CharlestonWVRecruiter Since 2001
the smart solution for Charleston jobs

Care Manager RN

Company: Aetna
Location: Charleston
Posted on: August 11, 2019

Job Description:

Description: Nurse Case Manager is responsible for telephonically and/or face to face assessing, planning, implementing and coordinating all case management activities with members to evaluate the medical needs of the member to facilitate the member's overall wellness. Develops a proactive course of action to address issues presented to enhance the short and long-term outcomes as well as opportunities to enhance a member's overall wellness through integration. Services strategies policies and programs are comprised of network management and clinical coverage policies. 62201 Fundamental Components: Through the use of clinical tools and information/data review, conducts an evaluation of member's needs and benefit plan eligibility and facilitates integrative functions as well as smooth transition to Aetna programs and plans. 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 to address all conditions including co-morbid and multiple diagnoses that impact functionality. Reviews prior claims to address potential impact on current case management and eligibility. Assessments include the member's level of work capacity and related restrictions/limitations. Using a holistic approach assess the need for a referral to clinical resources for assistance in determining functionality. Consults with supervisor and others in overcoming barriers in meeting goals and objectives, presents cases at case conferences for multidisciplinary focus to benefit overall claim 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 Bilingual preferred 3 years clinical practice experience; required RN with current unrestricted state licensure; required Psych RN or Behavioral Health experience; Preferred Additional Job Information: Typical office working environment with productivity and quality expectationsWork requires the ability to perform close inspection of hand written and computer generated documents as well as a PC monitor.Sedentary work involving periods of sitting, talking, listening. Work requires sitting for extended periods, talking on the telephone and typing on the computer.Ability to multitask, prioritize and effectively adapt to a fast paced changing environmentPosition requires proficiency with computer skills which includes navigating multiple systems and keyboardingEffective communication skills, both verbal and written. Education: Nursing - Registered Nurse Potential Telework Position: Yes Percent of Travel Required: 10 - 25% 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

Keywords: Aetna, Charleston , Care Manager RN, Healthcare , Charleston, West Virginia

Click here to apply!

Didn't find what you're looking for? Search again!

I'm looking for
in category
within


Other Healthcare Jobs


West Virginia Palliative Care Opening 190410
Description: Pain Management opening in Charleston, West Virginia. This and other physician jobs brought to you by DocCafe.com Join one of the best health care providers and teaching hospital in the state br br (more...)
Company: Pinnacle Health Group
Location: Charleston
Posted on: 08/24/2019

Nursing: Intermediate Care - Telemetry
Description: Nursing: Intermediate Care - TelemetryMedPro Healthcare Staffing, a Joint Commission-certified staffing agency, is seeking a quality Telemetry registered nurse for a travel assignment with one of our (more...)
Company: MedPro Healthcare Staffing
Location: Charleston
Posted on: 08/24/2019

Full time Opportunity for Orthopedic Surgeon with Hand Fellowship
Description: Orthopedics-Hand Surgery opening in Charleston, West Virginia. This and other physician jobs brought to you by DocCafe.com Full time Hospital Employment opportunity for a BC/BE fellowship-trained Orthopedic (more...)
Company: Charleston Area Medical Center
Location: Charleston
Posted on: 08/24/2019


Nursing: Oncology (Infusion)
Description: Nursing: Oncology Infusion MedPro Healthcare Staffing, a Joint Commission-certified staffing agency, is seeking a quality Oncology Registered Nurse RN for a travel assignment with one of our top healthcare (more...)
Company: MedPro Healthcare Staffing
Location: Charleston
Posted on: 08/24/2019

OBGYN Physician Gynecology Only - Physicians Only Apply - Perm
Description: Medical Doctors Only Apply. A OBGYN Physician Gynecology Only practice is seeking a qualified physician for Huntington, WV. This and other physician jobs brought to you by ExactMD. br br ul br (more...)
Company: Continuum Physician Recruiting
Location: Huntington
Posted on: 08/24/2019

ENT
Description: Otolaryngology opening in Huntington, West Virginia. This and other physician jobs brought to you by DocCafe.com br Medical Center is seeking a Board Certified or Board Eligible ENT. br 13 13 (more...)
Company: Spot On Recruiting, Inc.
Location: Huntington
Posted on: 08/24/2019

Employment Opportunity for Child Psychiatrist - Outpatient
Description: Psychiatry-Child/Adolescent opening in Charleston, West Virginia. This and other physician jobs brought to you by DocCafe.com The Charleston Area Medical Center is recruiting a full-time Child Psychiatrist (more...)
Company: Charleston Area Medical Center
Location: Charleston
Posted on: 08/24/2019

RN/RN-Infusion
Description: Infusion Assignment: Charleston, WV Coastal Healthcare Resources, Inc. is looking for qualified candidates for an assignment in Charleston, WV. This assignment
Company: Coastal Healthcare Resources, Inc.
Location: Charleston
Posted on: 08/24/2019

Emergency Medicine Physician Job near Jackson, West Virginia
Description: Emergency Medicine opening in Charleston, West Virginia. This and other physician jobs brought to you by DocCafe.com Emergency Medicine Physician Job in Jackson WV Join this independent smaller EM group
Company: HDA MD Staff
Location: Charleston
Posted on: 08/24/2019

Academic Vascular Surgeon Opportunity in Capital City of West Virginia
Description: Academic/Faculty/Research opening in Charleston, West Virginia. This and other physician jobs brought to you by DocCafe.com The Department of Surgery is seeking a Vascular Surgeon for a fulltime academic (more...)
Company: Charleston Area Medical Center
Location: Charleston
Posted on: 08/24/2019

Log In or Create An Account

Get the latest West Virginia jobs by following @recnetWV on Twitter!

Charleston RSS job feeds