What are the responsibilities and job description for the Nurse Case Manager II position at Aetna, a CVS Health Company?
Here are the job details for your review:
Job Title: Nurse Case Manager II
Job Location: This is a Remote (Only for MI state Residents)
Pay Rate: $35.36/HR on W2
Duration: 6 Months (Possibility of extension)
Client Name: CVS Health
Shift: 8 am - 5 pm Mon – Fri - EST
Job Description:
MI residents and MI RN license.
The Case Manager utilizes a collaborative process of assessment, planning, facilitation and advocacy for options and services to meet an individual's benefit plan and/or health needs through communication and available resources to promote optimal, cost-effective outcomes. Requires an RN with an unrestricted active license
Through the use of clinical tools and information/data review, conducts comprehensive assessments of referred member's needs/eligibility and determines approach to case resolution and/or meeting needs by evaluating member's benefit plan and available internal and external programs/services
Application and/or interpretation of applicable criteria and guidelines, standardized case management plans, policies, procedures, and regulatory standards while assessing benefits and/or member’s needs to ensure appropriate
administration of benefits
Utilizes case management and quality management processes in compliance with regulatory and accreditation guidelines and company policies and procedures
Required Qualifications
2-3 years Clinical practice experience, e.g., hospital setting, alternative care setting such as home health or ambulatory care required.
2 years Healthcare and/or managed care industry experience.
Case Management experience required-- Position requires proficiency with computer skills which includes navigating multiple systems and keyboarding
Effective communication skills, both verbal and written.
Ability to multitask, prioritize and effectively adapt to a fast paced changing environment
Sedentary work involving periods of sitting, talking, listening. Work requires sitting for extended periods, talking on the telephone and typing on the computer.
Work requires the ability to perform close inspection of hand written and computer generated documents as well as a PC monitor.
Typical office working environment with productivity and quality expectations
The Case Manager utilizes a collaborative process of assessment, planning, facilitation and advocacy for options and services to meet an individual’s benefit plan and/or health needs through communication and available resources to promote optimal, cost-effective outcomes.
Requires an MI RN with unrestricted active license
Education:
Registered Nurse with active state license in good standing in MI
Job Type: Contract
Salary: $33.00 - $35.00 per hour
Experience:
- Clinical Practice: 2 years (Required)
- Case management: 2 years (Required)
- managed care: 2 years (Required)
License/Certification:
- RN Michigan (Required)
Work Location: Remote
Salary : $35