Aetna Insurance Careers – Community Health Worker

Job Description:

As part of the bold vision to deliver the “Next Generation” of managed care in Ohio Medicaid, Ohio RISE will help children and their families who are experiencing barriers to achieve positive health outcomes and high quality of life indicators by developing person-centered and strengths based innovative solutions and creating partnerships among MCOs, vendors, and ODM to support specialization in addressing critical needs. The OhioRISE Program is designed to provide comprehensive and highly coordinated behavioral health services for children with serious/complex behavioral health needs involved in, or at risk for involvement in, multiple child-serving systems.

Job Responsibilities:

• Assist members to identify socio-economic issues that affect their overall health and develop health/social management plans and goals.
• Work to reduce cultural and socio-economic barriers between clients and institutions.
• Travel extensively to client homes, community locations, various agencies, and other outreach destinations.
• Teach disease self-management (i.e., nutrition, symptom tracking and reporting).
• Identify gaps and opportunities to strengthen systems of care within the member’s community and assists members in utilizing community services, including scheduling appointments with social services agencies, (including transportation vendors), and assisting with completion of applications for eligible programs.
• Educate healthcare professionals and providers on opportunities for improving and understanding the social determinants of health that may be impacting member’s health and treatment plan through various communication channels.
• Enter and maintain member records in electronic health record system, compile reports and complete other program documentation in a timely manner (e.g., progress notes, letters), and other administrative responsibilities as needed.
• Accompany members to appointments as needed.
• Build and maintain positive working relationships with the Aetna members, providers, nurse case managers, agency representatives, supervisors and office staff, from diverse cultural and socio-economic backgrounds.
• Conduct home visits with Aetna members with chronic conditions to assist them with their care plan including identifying the options that best meet the needs of the member, adjusting tasks to fit with the member’s culture, language, and religion, improving access to care, identifying health care needs, and reducing unnecessary hospitalizations to help the individual obtain positive health goals
• Assist with patient medication adherence by educating and instructing the member on current medication list, reviewing medications with member and assist in obtaining refills, and identifying alternatives if necessary.

Job Requirements:

• Ability to work collaboratively in a team and manage multiple priorities, utilizes effective time management skills, and exercise sound judgment.
• Ability to effectively provide support care to socially and medically complex patients in a variety of non-traditional settings.
• Strong interpersonal and communication skills and the ability to work effectively with a wide range of constituencies in a diverse community.
• Ability to travel up to 70% of the time to multiple office locations and home locations within the region. Travel is with personal vehicle. Must possess reliable transportation, valid/active driver’s license, and proof of vehicle insurance.
• Able to influence medical care providers as needed to adjust interventions based on member’s cultural, ethnic, or religious preferences.
• Knowledge of formal and informal community agencies and resources. Working knowledge of multi-system outreach programs related to health care delivery, clinical education, and health-related services.
• Exceptional organizational and interpersonal skills, with attention to detail required.
• Requires flexibility to work in situations in which the working conditions are unknown, as environments and situation of patient homes may vary.
• Ability to communicate medical information to health care professionals and care coordinators over the telephone.

Job Details:

Company: Aetna

Vacancy Type:  Full Time

Job Location: Columbus, OH, US

Application Deadline: N/A

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