Case Management Coordinator

AETNA – Princeton, NJ

Please note, this is an in office position in Princeton, NJ POSITION SUMMARY Utilizes critical thinking and judgment to collaborate and inform the case management process, in order to facilitate appropriate healthcare outcomes for members by providing care coordination, support and education for members through the use of care management tools and resources. Fundamental Components:Evaluation of Members: Through the use of care management tools and information/data review, conducts comprehensive evaluation of referred members needs/eligibility and recommends an approach to case resolution and/or meeting needs by evaluating members benefit plan and available internal and external programs/services. Identifies high risk factors and service needs that may impact member outcomes and care planning components with appropriate referral to clinical case management or crisis intervention as appropriate. Coordinates and implements assigned care plan activities and monitors care plan progress. Enhancement of Medical Appropriateness and Quality of Care: Using holistic approach consults with case managers, supervisors, Medical Directors and/or other health programs to overcome barriers to meeting goals and objectives; presents cases at case conferences to obtain multidisciplinary review in order to achieve optimal outcomes. Identifies and escalates quality of care issues through established channels. Utilizes negotiation skills to secure appropriate options and services necessary to meet the members benefits and/or healthcare needs. Utilizes influencing/ motivational interviewing skills to ensure maximum member engagement and promote lifestyle/behavior changes to achieve optimum level of health. Provides coaching, information and support to empower the member to make ongoing independent medical and/or healthy lifestyle choices. Helps member actively and knowledgably participate with their provider in healthcare decision-making. Monitoring, Evaluation and Documentation of Care: Utilizes case management and quality management processes in compliance with regulatory and accreditation guidelines and company policies and procedures. BACKGROUND/EXPERIENCE desired: 2+ years experience in behavioral health, social services or appropriate related field equivalent to program focus is required Managed Care experience preferred Case management and discharge planning experience preferred EDUCATION The minimum level of education desired for candidates in this position is a Bachelor's degree or equivalent experience. ADDITIONAL JOB INFORMATION 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. Aetna takes our candidates'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 for information will be discussed prior and will be conducted through a secure website provided by the recruiter. Should you be asked for such information, please notify us immediately. 57387

All Jobs in Princeton, NJ

  • (Medication Assisted Treatment) MAT Program Coordinator

    Henry J Austin Health Center Trenton, NJ

    View Job
  • Coordinator 423

    SERV Behavioral Health System, Inc. Mercer County, NJ

    View Job
  • RESIDENTIAL SUPPORT LEADER

    Advancing Opportunities Mercer County, NJ

    View Job
  • Kinship Care Coordinator

    Partnership for Strong Families, Inc. Trenton, NJ

    View Job
  • Clinical Coordinator

    TRIPLE C HOUSING North Brunswick, NJ

    View Job
  • Coordinator 423

    SERV Behaviorial Health System, Inc. Trenton, NJ

    View Job
  • Support Coordinator

    Solutions For U New Brunswick, NJ

    View Job
  • Support Coordinator

    Solutions For U Flemington, NJ

    View Job
  • Floating MDS Coordinator (CRC - RNAC) (Full Time)

    Genesis Staffing Services Mercerville, NJ

    View Job
  • Youth Program Coordinator

    MENTOR NETWORK Township of Millstone, NJ

    View Job
  • Program Coordinator

    Rutgers University Piscataway, NJ

    View Job

Featured Articles

SAP EP Online Training Knowledge Management Full Module

28 April 2016

SAP Enterprise Portal (EP) is one of the foundations of SAP Net Weaver architecture. SAP EP involves the collaboration add-on abilities and knowledge management. It gives access to culture venture, business operations and content management across various depletion channels. It integrates data and a

read more..

Best SAP SEM Online Training For Improved Managment

28 April 2016

SAP SEM (Strategic Enterprise Management ) is the concept to enable value-based management. It is a critical analysis based application that deals with SAP warehouse. It is organized into following components: SRM – stakeholder relationship management, BCS – business conso

read more..

Spring Online Training Program Full Content

20 April 2016

Spring is Java’s most popular application framework. Spring is capable of managing the application’s life cycle. It creates beans in the right order and they are fully initialized before use. Each bean is bound to a unique ID. Spring is useful for any tier of any Java application. It covers all

read more..

Reasons To Take Up BA QA Training and Placement in USA

24 September 2015

Business Analyst’s work is related to company’s business where the person has to work with client mapping and defining the business requirements. Whereas the term QA means Quality Analyst who develops, executes and test the code for the software and also the working of software. Their duty is to

read more..

Thanks For Your Feedback

OPT Nation© 2018 Powered By Ragns Inc

Attach A Resume First