Aetna Registered Nurse (RN) - Case Manager in San Antonio, Texas

Req ID: 37365BR

POSITION SUMMARY

The Nurse Case Manager is responsible for telephonically assessing, planning, implementing and coordinating all case management activities with members to evaluate the medical and disability needs of the member to facilitate the member's overall wellness and appropriate and timely return to work. In doing this the NCM 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 members overall wellness through integration. Services strategies policies and programs are comprised of network management and clinical coverage policies.

Fundamental components include, but are not limited to:

  • Proficiency with computer skills, which includes navigating multiple systems and keyboarding.

  • Effective communication skills, both verbal and written.

  • Ability to multitask, prioritize and effectively adapt to a fast paced changing environment

  • Sedentary work involving periods of sitting, talking, listening. Work requires sitting for extended periods, talking on the telephone and typing on the computer.

  • Work requires the ability to perform close inspection of hand written and computer generated documents as well as a PC monitor.

  • Typical office working environment with productivity and quality expectations.

    BACKGROUND/EXPERIENCE

  • Minimum of 5 years of Nursing experience required.

  • Case Management experience preferred.

  • Managed Care preferred.

    EDUCATION

    The minimum level of education desired for candidates in this position is a Bachelor's degree or equivalent experience.

    LICENSES AND CERTIFICATIONS

    Nursing/Registered Nurse is required

    Nursing/Certified Case Manager is desired

    FUNCTIONAL EXPERIENCES

    Case Management/1-3 Years

    Discharge Planning/1-3 Years

    Disease management/1-3 Years

    Concurrent Review/discharge planning/1-3 Years

    TECHNOLOGY EXPERIENCES

    Microsoft Word/4-6 Years

    TE Microsoft Excel/4-6 Years

    Microsoft Explorer/7-10 Years

    Software Management/1-3 Years

    REQUIRED SKILLS

    Benefits Management/Maximizing Healthcare Quality

    Benefits Management/Understanding Clinical Impacts

    General Business/Applying Reasoned Judgment

    DESIRED SKILLS

    Finance/Managing Aetnas Risk/FOUNDATION

    General Business/Turning Data into Information/FOUNDATION

    Leadership/Collaborating for Results/ADVANCED

    ADDITIONAL JOB INFORMATION

    In-office position, option for telework will be evaluated after a certain period of employment.

    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.

    Benefit eligibility may vary by position. Click here to review the benefits associated with this position.

Job Function: Health Care