Multiple Case Management Nurse Consultants (RN) Needed

Job Status: Full TimeJob Category: Medical/HealthEducation Level: Associate DegreeExperience Required: 2+ to 5 Years Email this Job to a Friend | See All Aetna Opportunities | Learn more about Aetna We are a company built on excellence. We have a culture that values growth, achievement and diversity and a workplace where your voice is heard. Multiple Case Management Nurse Consultants (RN) Needed Job Description ABOUT OUR COMPANY We are a company built on excellence. We have a culture that values growth, achievement and diversity and a workplace where your voice can be heard. JOB GROUP SUMMARY The dedication of talented and caring health care professionals drives the delivery of high quality, cost effective products and services. They make it possible for members to get the right health care treatment for their needs and for Aetna to keep its competitive edge. Job Responsibilities: These positions will support Home Depot business under the Flexible Medical Management Model. The nurse case manager will be coordinating cost effective care, returning members to optimal health, increasing member and provider satisfaction through collaborative care and targeted interventions. Responsibilities include, but not limited to: assessing member s care needs, coordinating case plans in collaboration with member, members family and interdisciplinary team, performing regular evaluations of member progress and discontinuing CM services when closure criteria met.  Comprehensive knowledge of the Managed Care environment. Ability to verify eligibility, coverage and benefit limitations in appropriate on line systems. Conduct initial screening of referred cases for appropriateness for case management. Identify needs for intervention to impact quality of life. Assess appropriate care setting and ancillary resources within benefit parameters. Collect clinical information from a variety of sources, establish levels of intensity, accept or decline member for case management and provide feedback to referral source.  Communication between member and all members of the case management healthcare team is paramount throughout the case management process. Required Skills: -RN with current state license -Minimum 3-5 yrs recent utilization/discharge planning/case management experience. Degree/certification preferred, e.g. BSN, CCM etc. CCM preferred. -Excellent written and verbal communication skills in addition to computer knowledge of Excel and Word a must. The successful candidates must live in the greater Atlanta, GA area. These positions will be telework/WAH positions. Initial training will require that you travel to the site daily. Must be available to travel to site as needed to meet the business requirements.