Aetna Jobs – Case Management Coordinator

Job Description:

The Intensive Care Management Coordinator (CMC) is a field based position. This position utilizes critical thinking and professional judgment to collaborate and support the case management process, in order to facilitate improved healthcare outcomes for members with intensive physical and/or behavioral care needs by providing advocacy, coordination, collaboration, support and education through the use of care management tools and resources. This position requires routine regional in-state travel 80-90% of the time; use of personal vehicle is required. Qualified candidates must have valid KY driver’s license, proof of vehicle insurance, and reliable transportation. Travel to the Louisville office is also anticipated for meetings and training. This position is assigned to the Two Rivers region. Qualified candidates may reside in or adjacent to the assigned region.

Job Responsibilities:

• Provides modifications to care plan to reflect changing needs.
• Provide crisis support and stabilization as needed.
• Enhancement of Medical Appropriateness and Quality of Care: Using holistic approach consults with case managers, supervisors, Medical Directors and/or other health programs to overcome barriers to meeting goals and objectives; presents cases at case conferences to obtain multidisciplinary review in order to achieve optimal outcomes.
• Identifies and escalates quality of care issues through established channels.
• Utilizes negotiation skills to secure appropriate options and services necessary to meet the member’s benefits and/or healthcare needs.
• Utilizes influencing/ motivational interviewing skills to ensure maximum member engagement and promote lifestyle/behavior changes to achieve optimum level of health.
• Provides coaching, information and support to empower the member to make ongoing independent medical and/or healthy lifestyle choices.
• Helps member actively and knowledgably participate with their provider in healthcare decision-making.
• Monitoring, Evaluation and Documentation of Care: Utilizes case management and quality management processes in compliance with regulatory and accreditation guidelines and company policies and procedures.

Job Requirements:

• Willing and able to travel 80-90% of their time using their own vehicle to meet members face to face in Daviess, Hancock, Henderson, Webster, Union, Ohio, Butler, Edmonson, Hart, Metcalfe, Barren, Warren, Logan, Allen, Monroe counties of KY and surrounding areas.
• Managed Care experience preferred.
• Minimum 2 years of experience in behavioral health, social services or human service field.
• Experience and detailed knowledge of the Foster Care and juvenile justice systems, Adoption Assistance, Trauma-informed Care, ACEs, Crisis Intervention services, and evidence-based practices applicable to the Kentucky SKY populations.
• Computer literacy and demonstrated proficiency is required in order to navigate through internal/external computer systems, and MS Office Suite applications, including Word and Excel.
• Valid Driver’s License required.
• Experience in the delivery of Behavior Health Services and knowledge of best practice treatment delivery systems for intensive member care needs.
• Case management and discharge planning experience preferred.
• Minimum of a Bachelor’s or Master’s degree or a non-licensed master level clinician is required; with either degree being in behavioral health or a relevant human services field of study required(social work, psychology, marriage and family therapy, counseling).

Job Details:

Company: Aetna

Vacancy Type:  Full Time

Job Location: Louisville, KY, US

Application Deadline: N/A

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