Workers Compensation RN Field Case Manager Registered Nurse SPANISH
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. Excellent benefits package, including 401k, tuition, licensure and certification reimbursement. We promote healthy & wellness lifestyles and offer specialty programs here at Aetna. 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.
Description
JOIN OUR GROWING TEAM
Are you tired of bedside nursing? Are you looking to get away from 12‑hour hospital shifts while continuing to utilize your RN expertise to impact the lives of patients in your local community?
We are seeking self‑motivated, energetic, detail‑oriented, highly organized, tech‑savvy Registered Nurses to join our Workers’ Compensation Field Case Management team. This opportunity offers a competitive salary, full benefits, and a performance‑based bonus paid out on a monthly or quarterly basis. Our organization promotes autonomy through a Monday‑Friday working schedule, paid holidays, and flexibility as you coordinate the care of your members.
Responsibilities
- Assess and analyze injured employees to evaluate medical and vocational needs needed to facilitate appropriate and timely return to work.
- Act as a liaison with patient/family, employer, provider(s), insurance companies, and healthcare personnel.
- Implement and coordinate all case‑management activities related to catastrophic cases and chronically ill members across the continuum of care, including consultant referrals, home‑care visits, community resource utilization, and alternative levels of care.
- Interacts with members/clients telephonically or in person; may meet at homes, work‑sites, or physician’s office to provide ongoing case‑management services.
- Develop plans of care to facilitate membership wellness, medical outcomes, timely return to work, and determine eligibility for benefits.
- Communicate with members, providers, attorneys, employers, and carriers telephonically or in person.
- Prepare required documentation of case‑work activities and consult with multidisciplinary team members as indicated.
- Provide education and prevention information for optimal medical outcomes.
- Apply all applicable laws, regulations, carrier instructions, and referral source requirements.
- Testify as required to substantiate case work or reports.
- Conduct evaluations of member/ client needs and benefit eligibility, facilitate integrative functions using clinical tools and data, and monitor progress toward desired outcomes.
- Develop proactive courses of action to address issues and improve short and long‑term outcomes.
- Ensure injured workers receive timely and efficient care toward full rehabilitation and return to work; mileage reimbursement for local travel is provided.
Qualifications
- Registered Nurse (RN) with active & unrestricted state license in good standing in California.
- 2+ years of clinical nursing experience preferred.
- Prior case‑management and workers’ compensation experience preferred.
- Strong computer skills with experience in Microsoft Office (Word, Excel, Outlook).
- Excellent communication skills.
- Ability to multitask in a fast‑paced work environment.
- Must speak Spanish fluently.
Additional Information
- High initiative, challenging position utilizing critical thinking and effective communication.
- Evaluate medical and vocational needs to develop plan of care promoting successful return to work.
- Monitors progress toward desired outcomes in home, work site, and physician office settings.
- Opportunity to make a positive impact in the life of an injured worker.
Required Skills
- Case Administration
- Consulting for Solutions
- Managing Sales Relationships
Desired Skills
- Improving Constituent‑Focused Processes
- Providing Solutions to Constituent Needs
Functional Skills
- Nursing – Case Management
- Nursing – Disability
- Nursing – Home Health Care Ambulatory Nursing
- Nursing – Medical‑Surgical Care
- Nursing – Occupational
Technology Experience
- Microsoft Outlook
- Microsoft Word
- Microsoft Excel
Education
Registered Nurse (RN)
Potential Telework Position
Yes
Percent of Travel Required
75 – 100%
EEO Statement
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.
Benefit Eligibility
Benefit eligibility may vary by position. Click here to review the benefits associated with this position.
Candidate Privacy Information
Aetna takes our candidate's data privacy seriously. At no time will any Aetna recruiter or employee request any financial or personal information (Social Security Number, Credit card information for direct deposit, etc.) from you via e‑mail. Any requests are handled in accordance with privacy regulations.
Additional Job Information (reiterated)
- Work autonomously.
- No weekend or holiday work.
- Meet top doctors of their specialty and learn from them directly.
- Earn CEU free by attending free seminars and in‑house training.