Job Overview
Company:
Location:
Base Pay:
 N/A
Other Pay:
Employee Type:
 Full-Time
Industry:
 Healthcare - Health Services
Insurance
Managed Care
Manages Others:
 Yes
Job Type:
 Health Care
Insurance
Nurse
Req'd Education:
 4 Year Degree
Req'd Experience:
 At least 3 year(s)
Req'd Travel:
 Negligible
Relocation Covered:
 No
Reference ID:
27745002_306221658
 
  
Contact:
Not Available
Phone:
Not Available
Email:
Send Email Now
Fax:
Not Available
 

company overview

Aetna is one of the nation’s leading diversified health care benefits companies, serving members with information and resources to help them make better informed decisions about their health care.

Aetna offers a broad range of traditional and consumer-directed health insurance products and related services, including medical, pharmacy, dental, behavioral health, group life, long-term care and disability plans and medical management capabilities. Our customers include employer groups, individuals, college students, part-time and hourly workers, health plans and government-sponsored plans.

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Care Management Nurse Manager (RN)    
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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.


The Manager is responsible for oversight/management of medical services staff including the organization and development of high performing teams. Responsible for the implementation of Aetna's medical management services policies and procedures. Communicates strategic plan and specific tactics to meet plan. Ensures implementation of tactics to meet strategic direction for case management/patient management cost and quality outcomes. Creates direction and communicates a business case for change by focusing on and addressing key priorities to achieve business results. Ensures regional consistency with national program strategic direction and design. Identifies opportunities to implement best practice approaches and introduce innovations to better address the member's needs across the continuum of care. Accountable for meeting the financial, operational and quality objectives of the unit.

ADDITIONAL JOB INFORMATION
5-7 years of clinical experience.

Management experience in a clinical setting desired

Ability to communicate effectively with Providers, Members, and Staff & Upper Management in both an oral and written format. e.g., may provide support to the sales staff & network staff via onsite customer visits and/or presentations.

Ability to evaluate and interpret clinical and utilization data, identify areas of improvement, and focus on interventions to improve outcomes.

Able to work with people in such a manner as to build high morale and group commitment to goals and objectives.

Computer literacy and experience familiarity with Excel, MS Word, and web-based applications desired.


job Requirements

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.

EDUCATION
The highest level of education desired for candidates in this position is a Bachelor's degree or equivalent experience.

LICENSES AND CERTIFICATIONS
  • Registered Nurse (RN) is required
  • Certified Case Manager (CCM) is desired

    FUNCTIONAL WORK EXPERIENCE
  • Management experience in a clinical setting required (min 2 years)
  • Minimum of 5 to 7 years post licensure clinical experience
  • Nurses: Concurrent Review/discharge planning
  • Medical Management: Medical Management - Case Management
  • Nurses: Clinical claim review and coding

    REQUIRED SKILLS
  • Collaborating for Results
  • Deal decisively with performance problems
  • Set individual performance expectations for staff
  • Allocate resources to meet work volume and performance standards
  • Identify medical trends and cost saving opportunities
  • Interpersonal Communication

    DESIRED SKILLS
  • Adapt coaching style to effectively support individuals different from self
  • Delegate activities to staff members with appropriate authorities and checkpoints
  • Provide employees with development opportunities to prepare for career growth
  • Engaging and Developing People

    We value leadership, creativity and initiative.  If you share those values and a commitment to excellence and innovation, consider a career with Aetna.

    How to apply
     
    To learn more about this opportunity, visit us at www.aetna.com/working . Under requisition # select 29509 and submit your resume. 
     
    We conduct pre-employment drug and background testing.
    Aetna does not permit the use of tobacco related products or drugs in the workplace. No agencies, please.
     
    Aetna is an Equal Opportunity/Affirmative Action Employer. M/F/D/V

    Aetna is committed to maintaining an environment in which all employees are treated equitably and given the opportunity within the context of the business to achieve their potential. Aetna's Affirmative Action responsibilities extend to women, minorities, persons with disabilities and veterans. Company policy also provides for equal opportunity for qualified individuals regardless of race, color, sex, national origin, religion, age, disability, veteran status, sexual orientation, gender identity or marital status.

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