Aetna Registered Nurse (RN) - Case Manager - Sign On Bonus! (CA MCD) - 48918BR in San Diego, California
Req ID: 48918BR
Registered Nurse (RN) Case Manager Aetna Better Health of California in San Diego, is offering a $3,000 Sign On Bonus for this position. We are looking for people who value excellence, integrity, caring, and innovation. In this role, you will be part of a team improving the lives of the most vulnerable in our population.
Our vision incorporates community-based health care that works. We value diversity. Align your career goals with Aetna Better Health of California, and we will support you all the way. Aetna is currently seeking a Registered Nurse (RN) Case Manager to join our California Medicaid team in San Diego. The RN Case Manager will mainly be responsible for utilizing advanced clinical judgment and critical thinking skills to facilitate appropriate physical and behavioral healthcare and social services for members. Additionally, the RN Case Manager will assess and plan member-centered care, direct provider coordination and collaboration, and coordinate psychosocial services to promote effective utilization of available resources, optimal member functioning, and cost-effective outcomes. Note: This San Diego position is eligible for telework. Training will be provided in our San Diego office location. Commencement of telework to be determined; typically after one year in the position and/or following successful completion of training and demonstrated performance with assigned case load. The position also requires routine field based travel 50-75% of the time, in San Diego county. Responsibilities of the RN Case Manager:· Utilize clinical tools to review member specific health information and conduct comprehensive assessments of referred members needs and eligibility · Collaborate with member care teams to determine an approach to resolve member issues or meeting needs by evaluating the members benefit plan and available internal and external programs, services, and resources· Apply clinical judgment to the incorporation of strategies designed to reduce risk factors and barriers and address complex clinical indicators which impact care planning and resolution of member issues· Use advanced clinical skills to perform crisis intervention with members experiencing behavioral health or medical crisis and refer them to the appropriate clinical and service providers for thorough assessment and treatment, as clinically indicated · Provide crisis follow up to members to help ensure they are receiving the appropriate treatment and services· Enhance medical appropriateness and quality of care· Monitor, evaluate, and document care Required Qualifications of the RN Case Manager:· 3+ years of clinical practice experience, preferably home health, hospital, ambulatory care, or similar Preferred Qualifications of the RN Case Manager:· Behavioral healthcare experience is strongly preferred · Case management and discharge planning is strongly preferred· Managed care experience is strongly preferred· Crisis intervention skills Education of the RN Case Manager:· The highest level of education desired is a Bachelor s degree or equivalent experience · Bachelor s of Science in Nursing (BSN) degree is preferred Licenses and Certifications:
An active and good-standing Registered Nurse (RN) license in the state of California is required.
Functional Experience:· Functional - Medical Management/Medical Management - Case Management/4+ Years· Functional - Clinical / Medical/Direct patient care (hospital, private practice)/4+ Years· Functional - Medical Management/Medical Management - Direct patient care/4+ Years· Functional - Medical Management/Medical Management - Discharge planning/4+ Years Technology Experience:· Technical - Desktop Tools/Microsoft Word/4+ Years/End User· Technical - Desktop Tools/TE Microsoft Excel/4+ Years/End User· Technical - Desktop Tools/Microsoft Outlook/4+ Years/End User· Technical - Desktop Tools/Microsoft SharePoint/1+ Years/End User
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.
Benefit eligibility may vary by position. Click here to review the benefits associated with this position.
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Job Function: Health Care