Job Description
Job Description
Sign Up now for Aetna National Clinical Hiring Event!
Aetna is growing and working to hire clinicians to support current and future clinical in all lines of our managed care business, including Commercial (Employer) contracts, Medicare, Medicaid and Utilization Management. We are hiring RNs, Social Workers (licensed Behavioral Health clinicians), and Case Management Coordinators with social services experience.
This virtual event is on Nov 9th from 9-3pm EST. If interested in learning more or to RSVP, please clicking on this link: http://adtrk.tw/tp/rj6_cJEIU-I.K
Join our Aetna team as an industry leader in serving dual eligible populations by utilizing best-in-class operating and clinical models. You can have life-changing impact on our members who are enrolled in Medicare and Medicaid and present with a wide range of complex health and social challenges. With compassionate attention and excellent communication, we collaborate with members, providers, and community organizations to address the full continuum of our members health care and social determinant needs. Join us in this exciting opportunity as we grow and expand dually eligible members to change lives in new markets across the country.
Position Summary/Mission
Our Care Managers are frontline advocates for members who cannot advocate for themselves. They are responsible for assessing, planning, implementing, and coordinating all case management activities with members to evaluate the medical needs of the member to facilitate the members overall wellness.
* Develops a proactive plan of care to address identified issues to enhance the short and long-term outcomes as well as opportunities to enhance a members overall wellness.
* Uses clinical tools and information/data review to conduct an evaluation of members needs and benefits.
* Applies clinical judgment to incorporate strategies designed to reduce risk factors and barriers and address complex health and social indicators which impact care planning.
* Conducts assessments that consider information from various sources, such as claims, to address all conditions including co-morbid and multiple diagnoses that impact functionality.
* Uses a holistic approach to assess the need for a referral to clinical resources and other interdisciplinary team members.
* Collaborates with supervisor and other key stakeholders in the members healthcare in overcoming barriers in meeting goals and objectives, presents cases at interdisciplinary case conferences
* Utilizes case management processes in compliance with regulatory and company policies and procedures.
* Utilizes motivational interviewing skills to ensure maximum member engagement and discern their health status and health needs based on key questions and conversation.
Pay Range
The typical pay range for this role is:
Minimum: 55,300
Maximum: 118,900
Please keep in mind that this range represents the pay range for all positions in the job grade within which this position falls. The actual salary offer will take into account a wide range of factors, including location.
Required Qualifications
* Minimum 3 or more years clinical practical experience.
* Registered Nurse with active license in good standing is required.
Preferred Qualifications
N/A
Education
Associates degree required
BSN preferred
Business Overview
Bring your heart to CVS Health Every one of us at CVS Health shares a single, clear purpose: Bringing our heart to every moment of your health. This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand - with heart at its center - our purpose sends a personal message that how we deliver our services is just as important as what we deliver. Our Heart At Work Behaviors support this purpose. We want everyone who works at CVS Health to feel empowered by the role they play in transforming our culture and accelerating our ability to innovate and deliver solutions to make health care more personal, convenient and affordable. We strive to promote and sustain a culture of diversity, inclusion and belonging every day. CVS Health is an affirmative action employer, and is an equal opportunity employer, as are the physician-owned businesses for which CVS Health provides management services. We do not discriminate in recruiting, hiring, promotion, or any other personnel action based on race, ethnicity, color, national origin, sex/gender, sexual orientation, gender identity or expression, religion, age, disability, protected veteran status, or any other characteristic protected by applicable federal, state, or local law. We proudly support and encourage people with military experience (active, veterans, reservists and National Guard) as well as military spouses to apply for CVS Health job opportunities.
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