Aetna RN- Field Case Mgr-Medical - Registered Nurse (CCM, COHN, CRRN, CDMS) in Kissimmee, Florida
Req ID: 43605BR
The Field Case Manager is responsible for assessing and analyzing an injured employee to evaluate the medical and vocational needs required to facilitate the patients appropriate and timely return to work. Acts as a liaison with patient/family, employer, provider(s), insurance companies, and healthcare personnel.
This role offers some flexibility in your schedule and a bonus program! It is a great opportunity to join a great team and be part of making an impact on members! You will spend up to 75% in local travel in this area!
You will work independently both in the home office environment as well as traveling in the field and making visits. The Case Manager sets their own schedule and works independently to reach the goals and the objectives set forth for the job and caseload. Other field Case Managers and the Manager are available for assistance and provide some team work to the position. This is a fast paced environment where the Case Manager can make a difference and each day has new challenges!!
Assesses and analyzes an injured employees medical and vocational status; develops a plan of care to facilitate the patients appropriate and timely return to work. Interviews patients in their homes, work-sites, or physicians office to provide ongoing case management services. Monitors patient progress toward desired outcomes through assessment and evaluation. Communicates both in-person and telephonically with patient, medical providers, attorneys, employers and insurance carriers; prepares all required documentation of case work activities. May arrange referrals, consultations and therapeutic services for patients; confers with specialists concerning course of care and treatment. Develops and administers educational and prevention programs. Applies all laws and regulations that apply to the provision of rehabilitation services; applies all special instructions required by individual insurance carriers and referral sources. Testifies as required to substantiate any relevant case work or reports. Performs other related duties as assigned.
Minimum of three years of clinical experience (Ortho, home health preferred!) Certification required: one of these is a must: CCM, CRRN, CDMS, or COHN Ability to travel within a designated geographic area for in-person case management activities Knowledge of laws and regulations governing delivery of rehabilitation services is preferred! Strong computer skills needed including Microsoft office! Experience in a managed care environment is highly preferred!
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)
Nursing/Certified Case Manager
Functional - Nursing/Medical-Surgical Care/4-6 Years
Functional - Nursing/Case Management/1-3 Years
Functional - Nursing/Occupational/1-3 Years
Technical - Desktop Tools/Microsoft Word/1-3 Years/End User
Technical - Remote Access/Cisco VPN (hardware and software suite)/1-3 Years/End User
Technical - Desktop Tools/Microsoft Outlook/1-3 Years/End User
Technical - Desktop Tools/TE Microsoft Excel/1-3 Years/End User
Full-Time Telework (WAH) with up to 75% local travel!
ADDITIONAL JOB INFORMATION
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.
Job Function: Health Care