Job Description: This role is work from home with travel required in Maricopa County, Arizona to visit members once COVID restrictions are lifted. Job Responsibilities: Provides coaching, information and support to empower the member to make ongoing independent medical and/or healthy lifestyle choices. Coordinates and implements assigned care plan activities and monitors care plan progress Utilizes influencing/ motivational interviewing skills to ensure maximum member engagement and promote lifestyle/behavior changes to achieve optimum level of health. Uses a holistic approach to overcome barriers to meet goals and objectives; presents cases at case conferences to obtain multidisciplinary review in order to achieve optimal outcomes. Utilizes negotiation skills to secure appropriate options and services necessary to meet the member’s benefits and/or healthcare needs. Identifies high risk factors and service needs that may impact member outcomes and care planning components with appropriate referrals. Utilizes case management processes in compliance with regulatory and accreditation guidelines and company policies and procedures. Helps member actively and knowledgably participate with their provider in healthcare decision-making. Monitoring, Evaluation, and Documentation of Care; Identifies and escalates quality of care issues through established channels. Job Requirements: 2+years’ Case Management experience working with people who have been designated as having a serious mental illness (SMI) and working with people who are elderly or have a physical disability. Critical areas to succeed- organization, collaboration and time management. 1+ documenting electronically using keyboard and multiple computer screens– navigating through internal/external computer systems, and MS Office Suite applications, including Word and Excel 1+ years Experience collaborating with medical professionals Bachelor’s degree in (social work, psychology, special education or counseling) or be a licensed registered nurse with BH experience Job Details: Company: Aetna Vacancy Type: Full Time Job Location: Phoenix, AZ, US Application Deadline: N/A Apply Here vacancyoptions.com
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