Case Manager, Registered Nurse

Description:

• Standard Working hours Monday through Friday 8:00 AM -5:00 PM Eastern Standard Time (EST)
• Help us elevate our patient care to a whole new level!
• 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 a 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 markets across the country.
• Our Integrated Care Management (ICM) 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 member’s overall wellness.
• The ICM care manager 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 member’s overall wellness.
• Additional responsibilities include using clinical tools and information/data review to conduct evaluations, applying clinical judgment to incorporate strategies, conducting assessments considering various sources, and using a holistic approach for referrals.

Requirements:

• Must have active and unrestricted Registered Nurse (RN) licensure in the state of New Jersey
• 3 years clinical practical experience preference: (diabetes, CHF, CKD, post-acute care, hospice, palliative care, cardiac) with Medicare members.
• 2 years Case Management, Discharge Planning, and/or Home Health Care Coordination experience
• Certified Case Manager preferred
• 2 years Care Management, Discharge Planning and/or Home Health Care Coordination experience preferred
• Bilingual preferred
• Confidence working at home/independent thinker, using tools to collaborate and connect with teams virtually
• Excellent analytical and problem-solving skills
• Effective communications, organizational, and interpersonal skills.
• Ability to work independently
• Effective computer skills including navigating multiple systems and keyboarding
• Demonstrates proficiency with standard corporate software applications, including MS Word, Excel, Outlook, and PowerPoint, as well as some special proprietary applications
• Bachelor’s of Science Degree in Nursing

Benefits:

• Affordable medical plan options
• 401(k) plan (including matching company contributions)
• Employee stock purchase plan
• No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.
• Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.

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