Case Manager Registered Nurse - Field (Camden County, NJ)

Summary

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.

Responsibilities

• Assess, plan, implement, and coordinate all case management activities with members to evaluate the medical needs of the member to facilitate the member’s overall wellness.
• Develop 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.
• Use clinical judgment to incorporate strategies designed to reduce risk factors and barriers and address complex health and social indicators which impact care planning.
• Conduct assessments that consider information from various sources, such as claims, to address all conditions including co-morbid and multiple diagnoses that impact functionality.
• Use a holistic approach to assess the need for a referral to clinical resources and other interdisciplinary team members.
• Collaborate with supervisor and other key stakeholders in the member’s healthcare in overcoming barriers in meeting goals and objectives, presents cases at interdisciplinary case conferences.
• Utilize case management processes in compliance with regulatory and company policies and procedures.
• Utilize motivational interviewing skills to ensure maximum member engagement and discern their health status and health needs based on key questions and conversation.

Requirements

• Minimum 3+ years of clinical practice experience
• Active and unrestricted RN licensure in the state of NJ
• Reside in/around Camden County, New Jersey within 50 miles of Camden County radius
• Reliable transportation and willingness to travel up to 50% of the time

Qualifications

• Associates Degree required
• Bachelor’s Degree in Nursing preferred
• Minimum 2+ years Care Management, Discharge Planning and/or Home Health Care Coordination experience
• Confidence working at home/independent thinker, using tools to collaborate and connect with teams virtually
• Effective analytical and problem-solving skills
• Effective communications, organizational, and interpersonal skills
• Able 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
• Bilingual preferred

Benefits

• Medical, dental, and vision coverage
• Paid time off
• Retail Savings options
• Wellness programs
• Other resources