Case Manager - Health & Care Coordination

Aetna; Saint Paul (MN); Remote; USD 28,000 - 41,000; Full time

Benefits offered by this job

Health benefits

Dental benefits

Vision benefits

401(k) plan

Stock purchase plan

Life insurance

Disability benefits

Wellness programs

Educational assistance

Paid time off

Job summary

Aetna is seeking a case management coordinator in the United States to coordinate care, support, and training for members using care management tools and resources. You will conduct audits, plan care activities, and promote optimal health outcomes through collaboration with multidisciplinary teams.

The role requires critical thinking, negotiation, and motivational interviewing to engage members and providers. Experience with care management processes and quality control is essential.

Qualifications

• Bachelor's degree or higher required.

Responsibilities

• Plan and implement assigned care plan activities and monitor care plan progress.
• Conduct multidisciplinary research to achieve the best results.
• Identify and expand the quality of care through established channels.
• Use negotiation skills to obtain the appropriate options and services needed to meet the member's health care needs and/or benefits.
• Use effective/motivational interviewing skills to ensure maximum team engagement and promote lifestyle/behavioral changes to achieve optimal health.
• Provide guidance, information and support to enable the member to make healthy and personal health and/or lifestyle choices.
• Help the member to actively and effectively work with their provider in making health care decisions.
• Use case management and quality control procedures based on legal and accreditation standards and company policies and procedures.

Skills

Critical thinking

Care coordination

Data analysis

Negotiation

Motivational interviewing

Provider collaboration

Case management

Quality control

Education

Bachelor's Degree

Job description

Aetna is seeking a case management coordinator in the United States to coordinate care, support, and training for members using care management tools and resources. You will conduct audits, plan care activities, and promote optimal health outcomes through collaboration with multidisciplinary teams.

The role requires critical thinking, negotiation, and motivational interviewing to engage members and providers. Experience with care management processes and quality control is essential.