Registered Nurse (RN) - Medicare Case Manager
Location: Portland Maine
Description: Aetna is in need of Registered Nurse (RN) - Medicare Case Manager right now, this job will be placed in Maine. For complete informations about this job opportunity please give attention to these descriptions. Req ID: 13375BR
Past experience working in Medicare or with geriatric patients is highly preferred. The candidate's background ideally will include nursi! ng experience in acute medical surgical along with home care/hospice experience and discharge planning.
In order to be considered, candidates must live within commuting distance to Aetna's Hartford CT, Blue Bell PA, or Tampa FL offices. Candidates who reside in commuting distance to the South Portland, ME office, you will be working from home directly after the first day of onboarding in the South Portland office.POSITION SUMMARY
The Case Manager RN Medicare utilizes a collaborative process of assessment, planning, facilitation and advocacy for options and services to meet an individual’s benefit plan and/or health needs through communication and available resources to promote optimal, cost-effective outcomes. The CM process includes: assessing the member's health status and care coordination needs, inpatient review and discharge planning, developing and implementing the case management plan, ongoing evaluation of the case plan with Medical Director involveme! nt as indicated and case closure when closure criteria achieve! d.
Experience in case management, home care and/or sub-acute nursing preferred. Current Case Management certification is a plus. Good time management and organizational skills along with the ability to manage continually changing priorities are needed. The ideal candidate must have excellent written and verbal communication skills. This position requires proficiency with computers. Computer skills include navigating in multiple systems and web-based applications, use of mouse and strong keyboarding skills. Familiar with Microsoft Word and Excel; ability to copy and paste.
EDUCATION
The highest level of education desired for candidates in this position is a Associate's degree or equivalent experience.
LICENSES AND CERTIFICATIONS
Nursing/Certification in Geriatrics is desired
Nursing/Certified Case Manager (CCM) is desired
Nursing/Registered Nurse (RN) is required
FUNCTIONAL EXPERIENCES
Functional - Nursing/Case Manageme! nt/1-3 Years
Functional - Nursing/Medical-Surgical Care/acute clinical experience/4-6 Years
Functional - Nursing/Disease management/1-3 Years
Functional - Nursing/Discharge Planning/1-3 Years
Functional - Nursing/Home Care/Hospice/1-3 Years
TECHNOLOGY EXPERIENCES
Technical - Desktop Tools/Microsoft Word/1-3 Years
Technical - Desktop Tools/Microsoft Outlook/1-3 Years
Technical - Desktop Tools/TE Microsoft Excel/1-3 Years
Technical - Aetna Applications/Aetna Total clinical View/1-3 Years
Technical - Aetna Applications/TE eTUMS -Total Utilization Management System Internet/1-3 Years
REQUIRED SKILLS
Benefits Management/Maximizing Healthcare Quality
Benefits Management/Supporting Medical Practice
Benefits Management/Understanding Clinical Impacts
DESIRED SKILLS
Leadership/Collaborating for Results
Service/Providing Solutions to Constituent Needs
General Business/Turning Data into Information Please note that benefit eligibility may vary by position. Clickhere! to review the benefits associated with this position.
Aetna does not permit the use of tobacco related products or drugs in the workplace.
Job Function: Health Care
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If you were eligible to this job, please email us your resume, with salary requirements and a resume to Aetna.
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This job starts available on: Sat, 17 Aug 2013 12:31:23 GMT