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Case Management Coordinator - Tampa, FL #6781863

Company: Aetna

Date: 09/11/2019

Category: Travel / Transportation

City: Tampa, FL

Req ID: 64258BR

Job Description

This role is work at home with 25-50% of travel required.

Responsible implementing and coordinating all case management, psychosocial, and quality of life activities relating to cases across the continuum of care including consultant referrals, home care visits, use of community resources and alternative levels of care.

Fundamental Components included but are not limited to:

  • Conducts comprehensive evaluation of Members using care

management tools and information/data review

  • Coordinates and implements assigned care plan activities

and monitors care plan progress

  • 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 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.

Qualifications Requirements and Preferences:

  • Case management experience preferred

  • Managed Care experience preferred

  • Bi-lingual Preferred

  • 2 years experience in behavioral health, social services preferred

  • Bachelor's degree or non-licensed master level clinician required, with either degree being in behavioral health or human services (psychology, social work, marriage and family therapy, counseling).

Technology Experience:

Desktop Tool - Microsoft Outlook, Desktop Tool - Microsoft Word, Desktop Tool - TE Microsoft Excel

Required Skills:

Benefits Management - Encouraging Wellness and Prevention, Benefits Management - Interacting with Medical Professionals, Service - Providing Solutions to Constituent Needs

Desired Skills:

Benefits Management - Understanding Clinical Impacts, Service - Handling Service Challenges, Service - Working Across Boundaries

Additional Job Information:

This role requires visits to be completed with our members at their private homes, Assisted Living Facilities, Adult Family Care Homes and Nursing Homes. When the candidate is not completing visits they will be working from their home office completing documentation, case notes and coordinating services.

The Candidate:

  • Must be willing & able to travel within the service area

  • Must have unrestricted driver's license, active insurance and reliable transportation

  • Must be self-motivated and able to work independently

  • Must be able to multitask and be priority driven

  • Must be detail oriented

  • Must be able to effectively and efficiently navigate various computer systems and programs

  • Must be able to meet documentation standards

Benefit Eligibility

Benefit eligibility may vary by position. Click here to review the benefits associated with this position.

Job Function: Healthcare

Aetna is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or protected Veterans status.

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