What are the responsibilities and job description for the RN Case Manager position at Aetna, a CVS Health Company?
Here are the job details for your review:
Job Title: Nurse Case Manager II
Job Location- Remote - MI
Duration: 5 Months Contract (Potential for extension)
Pay Rate:$44.12/HR on W2
Shift – M-F - 8AM-5 PM
Candidates need to be located in:
Individual must reside in one of these counties: Berrien, Van Buren, Cass, Kalamazoo, St. Joseph, Calhoun, Branch, Jackson, Hillsdale, Livingston, Washtenaw, Lenawee, Monroe, Oakland, Macomb, Wayne, Clinton, Eaton, or Ingham
Add city, state and county at the top of their resume.
Primarily telephonic. No field work needed for this role.
Fully remote. Candidates will need a quite, dedicated work space with no distractions. This role will require that the candidate be hard wired into the modem. Candidates will need to secure a long enough ethernet cord at their own expense.
Must have an active and unrestricted RN license in the state of Michigan.
Description
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 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
Experience
3 years Clinical practice experience, e.g., hospital setting, alternative care setting such as home health or ambulatory care required.
Healthcare and/or managed care industry experience.
Case Management experience preferred-- 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?
Education
RN with current unrestricted state licensure.
Case Management Certification ??CCM?? preferred.
Job Types: Full-time, Contract
Pay: $40.00 - $44.00 per hour
Experience:
- Good Clinical Practice: 3 years (Required)
- Case management: 2 years (Required)
License/Certification:
- RN License (Required)
Location:
- Michigan (Required)
Work Location: Remote
Salary : $40 - $44