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Aetna
Disability Nurse Case Mgr [Job Id: 27745004_106431645]

Working At Aetna -- the Value To You

What does it mean to work at Aetna? A lot.  From programs and benefits that support your financial, physical and emotional health to opportunities to build your knowledge and expand your career, the company makes working here a valuable experience in many ways.



POSITION SUMMARY
Utilizes clinical and case management skills to coordinate, document and communicate an assessment of function and/or impairment as it relates to the performance of specific job/occupation duties.

Fundamental Components:
Independently manages a claims caseload to ensure client requirements are achieved and internal policy and procedure requirements are met
Communicates claim determinations with members and provides them direction on appeal process, when applicable
Evaluates clinical information including non-clinical barriers to form a comprehensive claim decision with a strategic action plan
Negotiates and communicates with employers to identify opportunities for accommodations within the workplace for a safe and timely return to work
Leverages critical thinking, extensive clinical knowledge, experience and skills in a collaborative process to develop a comprehensive strategy for the member to reach a higher level of function and/or return to work. Analyzes medical conditions, including co-morbid conditions, to identify members for referral opportunities to integrate with other products, services and/or programs and partners across products to proactively assist the member.
Investigates and resolves issues surrounding conflicting clinical claim information to determine a strategy which results in a potential savings for the business. Analyzes medical conditions, including co-morbid conditions, to identify members for referral opportunities to integrate with other products, services and/or programs and partners across products to proactively assist the member.
Investigates and resolves issues surrounding conflicting clinical claim information to determine a strategy which results in a potential savings for the business.

BACKGROUND/EXPERIENCE desired:
RN with current unrestricted state (FL>)licensure required.
Associate's Degree in Nursing required.
Bachelor degree in Nursing preferred, but not required Position requires proficiency with computer skills which includes navigating multiple systems and keyboarding Effective communication skills, both verbal and written. Knowledge and ability to interact with medical professionals

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

LICENSES AND CERTIFICATIONS
Nursing/Registered Nurse is required for state of Florida.


FUNCTIONAL EXPERIENCES
- Clinical / Medical/Disability/1-3 Years
 - Nursing/Case Management/1-3 Years


ADDITIONAL JOB INFORMATION
* This is an office based position in Plantation, Florida.


Aetna is about more than just doing a job. This is our opportunity to re-shape healthcare for America and across the globe. We are developing solutions to improve the quality and affordability of healthcare. What we do will benefit generations to come.

We care about each other, our customers and our communities. We are inspired to make a difference, and we are committed to integrity and excellence.

Together we will empower people to live healthier lives.

Aetna is an equal opportunity & affirmative action employer. All qualified applicants will receive consideration for employment regardless of personal characteristics or status. We take affirmative action to recruit, select and develop women, people of color, veterans and individuals with disabilities.

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.

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

Required Skills:
RN with current unrestricted state (FL)licensure required.
Associate's Degree in Nursing required.
Bachelor degree in Nursing preferred, but not required Position requires proficiency with computer skills which includes navigating multiple systems and keyboarding Effective communication skills, both verbal and written. Knowledge and ability to interact with medical professionals
This posiiton is full-time with complete benefits packageand performance bonus.
The hours are Monday - Friday business hours.

How to apply
Please use the "Apply" link to apply to this position. If you cannot view this link, you can find this position on our website by visiting: www.aetna.com/working, click on apply online, search openings, and enter 32670BR in the keyword field. Additional information on what its like to work for Aetna and more can also be found on our website.

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


Aetna does not permit the use of tobacco related products or drugs in the workplace.

Aetna is an EO/AA Employer-Minorities/Women/Veterans/Disability.

No search firms please.

You will not be asked for personal information until you have been fully evaluated through Aetna's screening processes. Aetna will never ask applicants for money. If you want to verify the identity of someone who contacts you from Aetna, call 1-800-AETNAHR (1-800-238-6247).

Salary/Compensation:NA
Benefits:
Contact: http://www.ecentralmetrics.com/respond.cfm?posting=336205&bid=783  
Plantation FL US 33311
Posted: 04/21/2016
Full Time
Healthcare
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