49 jobs found in new albany

Aetna Description: This role is office based in New Albany, OH The required hours are Monday-Friday 8:00am - 4:30pm EST with an evening shift rotation 4-6 times per month Nurse Case Manager is responsible for telephonically and/or face to face assessing, planning, implementing and coordinating all case management activities with members to evaluate the medical needs of the member to facilitate the member's overall wellness. Develops a proactive course of action to address issues presented to enhance the short and long-term outcomes as well as opportunities to enhance a member's overall wellness through integration. Services strategies policies and programs are comprised of network management and clinical coverage policies. 64286 Fundamental Components: Through the use of clinical tools and information/data review, conducts an evaluation of member's needs and benefit plan eligibility and facilitates integrative functions as well as smooth transition to Aetna programs and plans. Applies clinical judgment to the incorporation of strategies designed to reduce risk factors and barriers and address complex health and social indicators which impact care planning and resolution of member issues. Assessments take into account information from various sources to address all conditions including co-morbid and multiple diagnoses that impact functionality. Reviews prior claims to address potential impact on current case management and eligibility. Assessments include the member's level of work capacity and related restrictions/limitations. Using a holistic approach assess the need for a referral to clinical resources for assistance in determining functionality. Consults with supervisor and others in overcoming barriers in meeting goals and objectives, presents cases at case conferences for multidisciplinary focus to benefit overall claim management. Utilizes case management processes in compliance with regulatory and company policies and procedures. Utilizes interviewing skills to ensure maximum member engagement and discern their health status and health needs based on key questions and conversation. Background Experience: -RN with current unrestricted state licensure required -3+ years clinical practice experience required -Case Management in an integrated model preferred -Bilingual preferred Additional Job Information: Typical office working environment with productivity and quality expectationsWork requires the ability to perform close inspection of hand written and computer generated documents as well as a PC monitor.Sedentary work involving periods of sitting, talking, listening. Work requires sitting for extended periods, talking on the telephone and typing on the computer.Ability to multitask, prioritize and effectively adapt to a fast paced changing environmentPosition requires proficiency with computer skills which includes navigating multiple systems and keyboardingEffective communication skills, both verbal and written. Functional Skills: Nursing - Case Management, Nursing - Concurrent Review/discharge planning Technology Experience: Desktop Tool - Microsoft Outlook, Desktop Tool - Microsoft Word Education: Nursing - Registered Nurse (RN) Percent of Travel Required: 0 - 10% EEO Statement: Aetna is an Equal Opportunity, Affirmative Action Employer 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 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.

Aetna Description: Customer Service Representative is the face of Aetna and impacts members' service experience by manner of how customer service inquiries and problems via telephone, internet or written correspondence are handled. Customer inquiries are of basic and at times complex nature. Engages, consults and educates members based upon the member's unique needs, preferences and understanding of Aetna plans, tools and resources to help guide the members along a clear path to care. 62182 Fundamental Components: Answers questions and resolves issues based on phone calls/letters from members, providers, and plan sponsors. Triages resulting rework to appropriate staff. Documents and tracks contacts with members, providers and plan sponsors. The CSR guides the member through their members plan of benefits, Aetna policy and procedures as well as having knowledge of resources to comply with any regulatory guidelines. Creates an emotional connection with our members by understanding and engaging the member to the fullest to champion for our members' best health. Taking accountability to fully understand the member's needs by building a trusting and caring relationship with the member. Anticipates customer needs. Provides the customer with related information to answer the unasked questions, e.g. additional plan details, benefit plan details, member self-service tools, etc. Uses customer service threshold framework to make financial decisions to resolve member issues. Explains member's rights and responsibilities in accordance with contract. Processes claim referrals, new claim handoffs, nurse reviews, complaints (member/provider), grievance and appeals (member/provider) via target system. Educates providers on our self-service options; Assists providers with credentialing and re-credentialing issues. Responds to requests received from Aetna's Law Document Center regarding litigation; lawsuitsHandles extensive file review requests. Assists in preparation of complaint trend reports. Assists in compiling claim data for customer audits. Determines medical necessity, applicable coverage provisions and verifies member plan eligibility relating to incoming correspondence and internal referrals. Handles incoming requests for appeals and pre-authorizations not handled by Clinical Claim Management. Performs review of member claim history to ensure accurate tracking of benefit maximums and/or coinsurance/deductible. Performs financial data maintenance as necessary. Uses applicable system tools and resources to produce quality letters and spreadsheets in response to inquiries received. Background Experience: Customer Service experiences in a transaction based environment such as a call center or retail location preferred, demonstrating ability to be empathetic and compassionate.Experience in a production environment. High School or GED equivalent. Additional Job Information: Ability to multi-task to accomplish workload efficiently. Understanding of medical terminology. Oral and written communication skills. Ability to maintain accuracy and production standards. Negotiation skills. Technical skills. Problem solving skills. Attention to detail and accuracy. Analytical skills. Potential Telework Position: No Percent of Travel Required: 0 - 10% EEO Statement: Aetna is an Equal Opportunity, Affirmative Action Employer 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 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.

Aetna Description: Support comprehensive coordination of medical services including Care Team intake, screening and supporting the implementation of care plans to promote effective utilization of healthcare services. Promotes/supports quality effectiveness of Healthcare Services. 62759 Fundamental Components: Responsible for initial review and triage of Care Team tasks.Identifies principle reason for admission, facility, and member product to correctly apply intervention assessment tools. Screens patients using targeted intervention business rules and processes to identify needed medical services, make appropriate referrals to medical services staff and coordinate the required services in accordance with the benefit plan. Monitors non-targeted cases for entry of appropriate discharge date and disposition.Identifies and refers outlier cases (e.g., Length of Stay) to clinical staff. Identifies triggers for referral into Aetna's Case Management, Disease Management, Mixed Services, and other Specialty Programs. Utilizes eTUMS and other Aetna systems to build, research and enter member information, as needed. Support the Development and Implementation of Care Plans. Coordinates and arranges for health care service delivery under the direction of nurse or medical director in the most appropriate setting at the most appropriate expense by identifying opportunities for the patient to utilize participating providers and services. Promotes communication, both internally and externally to enhance effectiveness of medical management services (e.g.,health care providers, and health care team members respectively). Performs non-medical research pertinent to the establishment, maintenance and closure of open cases. Provides support services to team members by answering telephone calls, taking messages, researching information and assisting in solving problems. Adheres to Compliance with PM Policies and Regulatory Standards. Maintains accurate and complete documentation of required information that meets risk management, regulatory, and accreditation requirements. Protects the confidentiality of member information and adheres to company policies regarding confidentiality. May assist in the research and resolution of claims payment issues. Supports the administration of the hospital care, case management and quality management processes in compliance with various laws and regulations, URAQ and/or NCQA standards, Case Management Society of America (CMSA) standards where applicable, while adhering to company policy and procedures. Background Experience: 2-4 years experience as a medical assistant, office assistant. High School Diploma or G.E.D. Additional Job Information: Effective communication, telephonic and organization skills. Familiarity with basic medical terminology and concepts used in care management. Strong customer service skills to coordinate service delivery including attention to customers, sensitivity to issues, proactive identification and resolution of issues to promote positive outcomes for members. Computer literacy in order to navigate through internal/external computer systems, including Excel and Microsoft Word. Ability to effectively participate in a multi-disciplinary team including internal and external participants. Functional Skills: Administration / Operation - Data Entry, Medical Management - Medical Management - Clinical claim review, Medical Management - Medical Management - Precertification Technology Experience: Aetna Application - Aetna Total clinical View, Desktop Tool - Microsoft Outlook Potential Telework Position: No Percent of Travel Required: 0 - 10% EEO Statement: Aetna is an Equal Opportunity, Affirmative Action Employer 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 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.

Nobel Learning Communities Job Code: 9818 Location: 516 School Brand: Ready Set Grow! City: New Albany School State: OH Ready Set Grow! New Albany, Ohio Our preschool builds the solid academic foundation students need for future success. In our school, classes are led by dedicated, caring teachers who value open communication with parents. Using our Links to Learning curriculum, our preschool offers the perfect balance of learning and play, combining structured learning experiences with play activities designed for each developmental stage. If you value a career in an educational community of extraordinary professionals, join ours! We are currently looking for a caring and energetic Preschool Teacher to join our team. If you have a passion for working with children, are dedicated to providing the best education and care to your students, work collaboratively, and want to learn and grow, we want you to be a part of our team. JOB DUTIES: Create, manage and participate in a variety of learning environments and activities that provide opportunities for students to develop to their fullest potential and achieve their learning objectives. Create and deliver lesson plans, implement school curriculum, and assess developmental needs of students. Maintain a healthy and safe environment. Communicate positively with students, parents, and staff. Participate collaboratively and professionally with other teachers and staff to promote the general well-being of the school, and collective/individual interest of its staff and student body. ESSENTIAL SKILLS & EXPERIENCE: Two (2) year degree in Early Childhood Education required or High School diploma (equivalent GED) coupled with life experience equivalent. Bachelor's Degree in Early Childhood Education preferred. Meets minimum preparation and experience required for certification as an Early Childhood Education Teacher. Complies with all state education and licensing standards, and maintains validation of credentials for the position (i.e. professional development). Previous experience as an Early Childhood Education Teacher, in a licensed preschool or early development center. Exhibits strong interpersonal and communication skills. Must be 18 years of age or older. BENEFITS: Competitive pay. Medical, dental, and vision insurance. Company paid life insurance; supplemental life insurance available. A 401(k) plan with matching employer contributions. Paid vacation, holidays, and sick time. Childcare tuition discounts. Flexible spending plans for both medical and dependent care. Educational assistance. Paid professional development days. The company is an Equal Opportunity Employer. M/F/D/V encouraged to apply.*

Nobel Learning Communities Job Code: 9535 Location: 516 School Brand: Ready Set Grow! City: New Albany School State: OH Ready Set Grow! New Albany, Ohio Our preschool builds the solid academic foundation students need for future success. In our school, classes are led by dedicated, caring teachers who value open communication with parents. Using our Links to Learning curriculum, our preschool offers the perfect balance of learning and play, combining structured learning experiences with play activities designed for each developmental stage. If you value a career in an educational community of extraordinary professionals, join ours! We are currently looking for a caring and energetic Preschool Teacher to join our team. If you have a passion for working with children, are dedicated to providing the best education and care to your students, work collaboratively, and want to learn and grow, we want you to be a part of our team. JOB DUTIES: Create, manage and participate in a variety of learning environments and activities that provide opportunities for students to develop to their fullest potential and achieve their learning objectives. Create and deliver lesson plans, implement school curriculum, and assess developmental needs of students. Maintain a healthy and safe environment. Communicate positively with students, parents, and staff. Participate collaboratively and professionally with other teachers and staff to promote the general well-being of the school, and collective/individual interest of its staff and student body. ESSENTIAL SKILLS & EXPERIENCE: Two (2) year degree in Early Childhood Education required or High School diploma (equivalent GED) coupled with life experience equivalent. Bachelor's Degree in Early Childhood Education preferred. Meets minimum preparation and experience required for certification as an Early Childhood Education Teacher. Complies with all state education and licensing standards, and maintains validation of credentials for the position (i.e. professional development). Previous experience as an Early Childhood Education Teacher, in a licensed preschool or early development center. Exhibits strong interpersonal and communication skills. Must be 18 years of age or older. BENEFITS: Competitive pay. Medical, dental, and vision insurance. Company paid life insurance; supplemental life insurance available. A 401(k) plan with matching employer contributions. Paid vacation, holidays, and sick time. Childcare tuition discounts. Flexible spending plans for both medical and dependent care. Educational assistance. Paid professional development days. The company is an Equal Opportunity Employer. M/F/D/V encouraged to apply.*

Aetna Description: Office Based Opportunity: New Albany, OH -- 7400 West Campus Road This position is for the Mercer Health Advantage In Touch Care Program. The hours of operation are 8:00 am to 4:30pm EST with a required an Evening Shift rotation 1:30 pm to 10:00 pm 1-2 times per month. The Case Manager utilizes a collaborative process of assessment, planning, facilitation and advocacy for options and services to meet an individual's benefit plan and/or health needs through communication and available resources to promote optimal, cost-effective outcomes. Requires an RN with unrestricted active license. 63932 Fundamental Components: Fundamental Components related to Aetna In Touch Care Program include but are not limited to: - Utilizes influencing/motivational interviewing skills to ensure maximum member engagement to achieve optimal outcomes, Utilizes assessment techniques to determine members level of health literacy, technology capabilities, and/or readiness to change. - 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. Background Experience: 3+ years of Clinical experience required 3+ years Medical Surgical experience required Strong computer and typing skills required Experience with patient education & discharge planning required RN unrestricted licensure required Additional Job Information: We are looking for a Case Manager to join the New Albany Dedicated Unit. Aetna In Touch Care model will be a combined case management and disease management focus. In this CM/DM role we are looking for a candidate who will assist with health care coordination, member satisfaction, and financial outcomes using targeted customer strategies and initiatives. The CM will provide telephonic member outreach for key educational and situational opportunities for increased case management and disease management identification and engagement. We will provide decision support and guidance for members and their families along with coordination of healthcare services. The Case Manager utilizes a collaborative process of assessment, planning, facilitation and advocacy for options and services to meet an individual's benefit plan and/or health needs through communication and available resources to promote optimal, cost-effective outcomes. Requires an RN with unrestricted active license. Minimum 3 to 5 years of recent experience. Strong knowledge of major health behavior models including Motivational Interviewing preferred. Must possess strong verbal, written communication skills, computer and keyboarding skills. Required Skills: Benefits Management - Understanding Clinical Impacts, General Business - Applying Reasoned Judgment, Service - Providing Solutions to Constituent Needs Desired Skills: Benefits Management - Supporting Medical Practice, General Business - Consulting for Solutions, Leadership - Collaborating for Results Functional Skills: Nursing - Case Management, Nursing - Concurrent Review/discharge planning, Nursing - Disease management, Nursing - Medical-Surgical Care Technology Experience: Aetna Application - Aetna Total clinical View, Desktop Tool - Microsoft Outlook, Desktop Tool - Microsoft Word, Operating System - Windows Education: Nursing - Certified Case Manager, Nursing - Registered Nurse (RN) Potential Telework Position: No Percent of Travel Required: 0 - 10% EEO Statement: Aetna is an Equal Opportunity, Affirmative Action Employer 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 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.

Walgreens Responsibilities Models and delivers a distinctive and delightful customer experience. Registers sales on assigned cash register and provides customers with courteous, fair, friendly, and efficient checkout service. Customer Experience Engages customers and patients by greeting them and offering assistance with products and services. Resolves customer issues and answers questions to ensure a positive customer experience. Models and shares customer service best practices with all team members to deliver a distinctive and delightful customer experience, including interpersonal habits (e.g., greeting, eye contact, courtesy, etc.) and Walgreens service traits (e.g., offering help proactively, identifying needs, servicing until satisfied, etc.). Develops strong relationships with most valuable customers. Operations Registers customer purchases on assigned cash register, collects cash and distributes change as requested; processes voids, returns, rain checks, refunds, and exchanges as needed. Recommends items for sale to customer and recommends trade-up and/or companion items. Assists with OTC products, and takes customer to aisle when possible. Operates pharmacy systems to obtain patient prescription status. Reports, immediately, prescription errors to pharmacist on duty and adheres to Company policies and procedures in relation to pharmacy errors and the Quality Improvement Program. Keeps counters and shelves clean and well merchandised, takes inventory, and maintains records. Checks in and prices merchandise as required or as directed by store manager or communicated by the shift leader. Implements Company asset protection procedures to identify and minimize profit loss. Ensures compliance with state and local laws regarding regulated products (e.g., alcoholic beverages and tobacco products). Constructs and maintains displays, including promotional, seasonal, super structures, and sale merchandise. Completes resets and revisions as directed. Has working knowledge of store systems and store equipment. Assists with exterior and interior maintenance by ensuring clean, neat, orderly store condition and appearance. Complies with all company policies and procedures; maintains respectful relationships with coworkers. Completes special assignments and other tasks as assigned. Training & Personal Development Attends training and completes PPLs requested by Manager or assigned by corporate.

Aetna Description: Acts as the primary resource for assigned, high profile providers or groups (i.e. local, individual providers, small groups/systems) to establish, oversee, and maintain positive relationships by assisting with or responding to complex issues regarding policies and procedures, plan design, contract language, service, claims or compensation issues, and provider education needs. 62772 Fundamental Components: Optimizes interactions with assigned providers and internal business partners to establish and maintain productive, professional relationships. Monitors service capabilities and collaborates cross-functionally to ensure that the needs of constituents are met and that escalated issues related but not limited to, claims payment, contract interpretation or parameters, and accuracy of provider contract or demographic information are resolved. Supports or assists with operational activities that may include, but are not limited to, database management, and contract coordination. Performs credentialing support activities as needed. Educates providers as needed to ensure compliance with contract policies and parameters, plan design, compensation process, technology, policies, and procedures. Meets with key providers periodically to ensure service levels are meeting expectations. Manages the development of agenda, validates materials, and facilitates external provider meetings. May collaborate cross-functionally on the implementation of large provider systems, to manage cost drivers and execute specific cost initiatives to support business objectives and to identify trends and enlist assistance in problem resolution. Conduct standard provider recruitment, contracting, or re-contracting activities and assist with more complex contracting and discussions as needed by business segment. May provide guidance and training to less experienced team members. Background Experience: 3+ years' experience in business segment environment servicing providers with exposure to benefits and/or contract interpretation. 3-5 years' experience with business segment specific policy, benefits, plan design and language. Strong verbal and written communication, interpersonal, problem resolution and critical thinking skills. Working knowledge of business segment specific codes, products, and terminology. Bachelor's Degree or equivalent combination of education and experience. Potential Telework Position: Yes Percent of Travel Required: 10 - 25% EEO Statement: Aetna is an Equal Opportunity, Affirmative Action Employer 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 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.

Aetna Description: This role is office based in New Albany, OH The required hours are Monday-Friday 8:00am - 4:30pm EST with an evening shift rotation 4-6 times per month Nurse Case Manager is responsible for telephonically and/or face to face assessing, planning, implementing and coordinating all case management activities with members to evaluate the medical needs of the member to facilitate the member's overall wellness. Develops a proactive course of action to address issues presented to enhance the short and long-term outcomes as well as opportunities to enhance a member's overall wellness through integration. Services strategies policies and programs are comprised of network management and clinical coverage policies. 63116 Fundamental Components: Through the use of clinical tools and information/data review, conducts an evaluation of member's needs and benefit plan eligibility and facilitates integrative functions as well as smooth transition to Aetna programs and plans. Applies clinical judgment to the incorporation of strategies designed to reduce risk factors and barriers and address complex health and social indicators which impact care planning and resolution of member issues. Assessments take into account information from various sources to address all conditions including co-morbid and multiple diagnoses that impact functionality. Reviews prior claims to address potential impact on current case management and eligibility. Assessments include the member's level of work capacity and related restrictions/limitations. Using a holistic approach assess the need for a referral to clinical resources for assistance in determining functionality. Consults with supervisor and others in overcoming barriers in meeting goals and objectives, presents cases at case conferences for multidisciplinary focus to benefit overall claim management. Utilizes case management processes in compliance with regulatory and company policies and procedures. Utilizes interviewing skills to ensure maximum member engagement and discern their health status and health needs based on key questions and conversation. Background Experience: -RN with current unrestricted state licensure required -3+ years clinical practice experience required -Case Management in an integrated model preferred -Bilingual preferred Additional Job Information: Typical office working environment with productivity and quality expectationsWork requires the ability to perform close inspection of hand written and computer generated documents as well as a PC monitor.Sedentary work involving periods of sitting, talking, listening. Work requires sitting for extended periods, talking on the telephone and typing on the computer.Ability to multitask, prioritize and effectively adapt to a fast paced changing environmentPosition requires proficiency with computer skills which includes navigating multiple systems and keyboardingEffective communication skills, both verbal and written. Functional Skills: Nursing - Case Management, Nursing - Concurrent Review/discharge planning Technology Experience: Aetna Application - Aetna Total clinical View, Desktop Tool - Microsoft Outlook, Desktop Tool - Microsoft Word Education: Nursing - Certified Case Manager (CCM), Nursing - Registered Nurse (RN) Potential Telework Position: No Percent of Travel Required: 0 - 10% EEO Statement: Aetna is an Equal Opportunity, Affirmative Action Employer 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 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.

Aetna Description: Supports comprehensive coordination of medical services including intake, screening and referrals to Aetna Medical Services Programs. Promotes/supports quality effectiveness of Healthcare Services. 62874 Fundamental Components: Performs intake of calls from members or providers regarding services via telephone, fax, EDI. Utilizes eTUMS and other Aetna system to build, research and enter member information. Screens requests for appropriate referral to medical services staff. Approve services that do not require a medical review in accordance with the benefit plan. Performs non-medical research including eligibility verification, COB, and benefits verification. Maintains accurate and complete documentation of required information that meets risk management, regulatory, and accreditation requirements. Promotes communication, both internally and externally to enhance effectiveness of medical management services (e.g., claim administrators, Plan Sponsors, and third party payers as well as member, family, and health care team members respectively) Protects the confidentiality of member information and adheres to company policies regarding confidentiality Communicate with Aetna Case Managers, when processing transactions for members active in this Program Supports the administration of the precertification process in compliance with various laws and regulations, URAQ and/or NCQA standards, where applicable, while adhering to company policy and procedures. Places outbound calls to providers under the direction of Medical Management Nurses to obtain clinical information for approval of medical authorizations. Uses Aetna Systems such as QNXT, ProFAX, ProPAT, and Milliman Criteria. Communicates with Aetna Nurses and Medical Directors, when processing transactions for members active in this Program. Sedentary work involving significant periods of sitting, talking, hearing and keying. Work requires visual acuity to perform close inspection of written and computer generated documents as well as a PC monitor. Working environment includes typical office conditions. Background Experience: 2-4 years experience as a medical assistant, office assistant or other clinical experience. High School Diploma or G.E.D. Additional Job Information: Effective communication, telephonic and organization skills. Familiarity with basic medical terminology and concepts used in care management. Strong customer service skills to coordinate service delivery including attention to customers, sensitivity to issues, proactive identification and resolution of issues to promote positive outcomes for members. Computer literacy in order to navigate through internal/external computer systems, including Excel and Microsoft Word. Ability to effectively participate in a multi-disciplinary team including internal and external participants. Potential Telework Position: No Percent of Travel Required: 0 - 10% EEO Statement: Aetna is an Equal Opportunity, Affirmative Action Employer 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 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.

Aetna Description: Under general direction, formulates and defines system scope and objectives. Devises or modifies procedures to solve complex problems considering computer equipment capacity and limitations, operating time and form of desired results. Prepares detailed technical specifications from which programs will be written. Designs, codes, tests, debugs, and documents those programs. Competent to work at the highest technical level of all phases of applications systems analysis and programming activities. Regularly provides guidance and training to less-experienced programmer/analysts. This position will be in an on call rotation supporting our applications and servers. 64061 Fundamental Components: 6+ years in database development experience including SQL Server 2012. Must have extensive database modeling, design, development, and maintenance experience. Proven experience with dimensional databases including SQL Server 2012. Skilled in both Data Warehouse and Transactional databases. Strong background in schema design and development. Extensive Stored Procedure development. Strong T-SQL programming skills. Experience developing SSIS ETL packages supporting database to database activities. Skilled in developing dimensional databases and data cubes Proven experience with SQL Server Analysis Services. Proven experience with SQL Server Reporting Services. Ability to design unit and system test plans, and execute testing. Extensive database administration experience Excellent communicator both verbally and written with coordination and facilitation skills. Ability to multi-task and complete in a timely manner multiple assignments. Provide 24/7 support on a rotation basis Health care experience a must. Background Experience: Expertise in one or more programming language, development tools, and/or databases and the systems development life cycle, applicable to development organization. 6+ years' experience in application program development, or an equivalent combination of education and work experience. Understand the business and functional requirements that apply to the applications supporting a sub-domain or domain as well as their relevant interfaces. 6+ years experience in systems analysis and application program development, or an equivalent combination of education and work experience. Experience with application development support software packages. Affiliated with a technical or professional organization or user group Bachelor's degree in Computer Science or an equivalent combination of education and experience. Additional Job Information: Ability to adapt to changing priorities.May act as Team Leader. May be involved in providing assistance and training to lower level Programmer/Analysts.Receives general supervision, and is competent to work at the highest level of all technical phases of systems analysis and application program development while working on own most of the time.Ability to work effectively with business areas, IT infrastructure teams, and IT management and staff.Broad knowledge of the client area's functions and systems, and systems and application program development technologies alternatives.Excellent communication skills. Required Skills: Technology - Developing Software Solutions Desired Skills: Technology - Developing Competitive Technology and Architecture, Technology - Leveraging Technology Functional Skills: Information Management - Data Warehousing, Information Management - Database Structures, Information Technology - Application development, Information Technology - Application maintenance & support, Information Technology - Infrastructure management Technology Experience: Database - Microsoft SQL Server, Development Experience - Client/Server, Development Tool - Microsoft Visual Studio, Operating System - .NET Framework Education: Information Technology - Microsoft Certified IT Professional (MCITP) Potential Telework Position: No Percent of Travel Required: 0 - 10% EEO Statement: Aetna is an Equal Opportunity, Affirmative Action Employer 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 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.

Aetna Description: Office-based position in New Albany, OH. The Care Manager utilizes a collaborative process of assessment, planning, facilitation and advocacy for options and services to meet an individual's benefit plan and/or health needs through communication and available resources to promote optimal, cost-effective outcomes. The CM process includes: assessing the member's health status and care coordination needs, inpatient review and discharge planning, developing and implementing the CM plan, monitoring and evaluating the plan and involving the Medical Director as indicated and closing the case as appropriate when the member has met discharge criteria. The responsibilities of this position are to apply data driven methods of identification of members to fashion individualized case management programs and/or referrals to alternative healthcare programs. Conducts comprehensive clinical assessments. Evaluates needs and develops flexible approaches based on member needs, benefit plans or external programs/services. Advocates for patients to the full extent of existing health care coverage. Promotes quality, cost effective outcomes and makes suggestions to improve program/operational efficiency. Identifies and escalates quality of care issues through established channels. Expectation is a very high level of customer service. 63936 Fundamental Components: Fundamental components related to the Aetna One Premier program include but are not limited to; Utilizes assessment techniques to determine member's level of health literacy, technology capabilities, and/or readiness to change. Utilizes influencing/motivational interviewing skills to ensure maximum member engagement and promote lifestyle/behavior changes to achieve optimum level of health. Provides coaching, information, education and support to empower the member to make ongoing independent medical and/or healthy lifestyle choices. Background Experience: RN licensure required 3+ years clinical experience required Case management experience preferred Managed care experience preferred Additional Job Information: Typical office working environment with productivity and quality expectationsWork requires the ability to perform close inspection of hand written and computer generated documents as well as a PC monitor.Sedentary work involving periods of sitting, talking, listening. Work requires sitting for extended periods, talking on the telephone and typing on the computer.Ability to multitask, prioritize and effectively adapt to a fast paced changing environmentPosition requires proficiency with computer skills which includes navigating multiple systems and keyboardingEffective communication skills, both verbal and written. Required Skills: Benefits Management - Supporting Medical Practice, Benefits Management - Understanding Clinical Impacts, Leadership - Collaborating for Results Desired Skills: Benefits Management - Maximizing Healthcare Quality, Finance - Managing Aetnas Risk, Service - Providing Solutions to Constituent Needs Functional Skills: Nursing - Case Management, Nursing - Clinical coverage and policies, Nursing - Concurrent Review/discharge planning, Nursing - Medical-Surgical Care Technology Experience: Aetna Application - Aetna Strategic Desktop Reporting, Aetna Application - Aetna Total clinical View, Desktop Tool - Microsoft Outlook, Desktop Tool - Microsoft Word Education: Nursing - Certified Case Manager, Nursing - Registered Nurse Potential Telework Position: No Percent of Travel Required: 0 - 10% EEO Statement: Aetna is an Equal Opportunity, Affirmative Action Employer 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 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.

Aetna Description: We are currently recruiting top talent for our Aetna Better Health Customer Service group located in New Albany, Ohio. The Dual Centers of Excellence Customer Service delivers innovative, proactive and compassionate service that exceeds our members expectations. We are the knowledgeable, trusted, advocates for our members. The key to our success is our people. 62742 Fundamental Components: Customer Service Representatives answer inquiries from our Center of Excellence members via inbound calls, internet inquiries, and written correspondence. CSRs must be able to deal compassionately with Medicaid beneficiaries on a one-on-one basis and focus on their needs through careful listening and patience. CSRs participate in ongoing training and engage in self-development. The CSR must be able to work independently, honor commitments to our members, and collaborate with team members to create a remarkable member experience. The position requires the ability to efficiently navigate multiple systems while resolving complex issues as advocates for our members. Passion for providing exceptional customer service, effective verbal and written communication skills, and willingness to adapt to a changing environment are critical to success in this role. Prior experience providing customer service to the senior population, knowledge of medical terminology including Medicare and Ohio Medicaid policies, or experience with health insurance plans is preferred. Background Experience: Experience in a production environment. Customer Service experiences in a transaction based environment such as a call center involving healthcare, insurance, or managed care industry is preferred; familiarity with Medicaid or Medicare a plus. Additional Job Information: Excellent attendance and punctuality are requirements of the Customer Service Representative position. CSRs are assigned 8.5 hour shifts, Monday through Friday from 8 am to 5 pm, which include a half-hour unpaid lunch time that may rotate as business needs dictate. CSRs must have the flexibility to work any time during the office hours of 8 am to 8 pm. At times, overtime including weekends may be required as business needs dictate. Required Skills: General Business - Maximizing Work Practices, Service - Handling Service Challenges, Service - Providing Solutions to Constituent Needs Desired Skills: Leadership - Driving a Culture of Compliance, Service - Demonstrating Service Discipline, Service - Working Across Boundaries Functional Skills: Communication - Member communications, Customer Service - Customer Service - Member Services - HMO products, Customer Service - Customer service - transaction based environment Technology Experience: Desktop Tool - Microsoft Explorer, Desktop Tool - Microsoft Outlook, Desktop Tool - Microsoft SharePoint, Operating System - Windows Potential Telework Position: No Percent of Travel Required: 0 - 10% EEO Statement: Aetna is an Equal Opportunity, Affirmative Action Employer 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 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.

Aetna Description: This role is office based in New Albany, OH. The required hours are Monday-Friday 10:00am-6:30pm EST with an evening shift rotation until 9pm approximately 2 times per month. Nurse Case Manager is responsible for telephonically and/or face to face assessing, planning, implementing and coordinating all case management activities with members to evaluate the medical needs of the member to facilitate the member's overall wellness. Develops a proactive course of action to address issues presented to enhance the short and long-term outcomes as well as opportunities to enhance a member's overall wellness through integration. Services strategies policies and programs are comprised of network management and clinical coverage policies. 63874 Fundamental Components: Through the use of clinical tools and information/data review, conducts an evaluation of member's needs and benefit plan eligibility and facilitates integrative functions as well as smooth transition to Aetna programs and plans. Applies clinical judgment to the incorporation of strategies designed to reduce risk factors and barriers and address complex health and social indicators which impact care planning and resolution of member issues. Assessments take into account information from various sources to address all conditions including co-morbid and multiple diagnoses that impact functionality. Reviews prior claims to address potential impact on current case management and eligibility. Assessments include the member's level of work capacity and related restrictions/limitations. Using a holistic approach assess the need for a referral to clinical resources for assistance in determining functionality. Consults with supervisor and others in overcoming barriers in meeting goals and objectives, presents cases at case conferences for multidisciplinary focus to benefit overall claim management. Utilizes case management processes in compliance with regulatory and company policies and procedures. Utilizes interviewing skills to ensure maximum member engagement and discern their health status and health needs based on key questions and conversation. Background Experience: -An RN with current unrestricted state licensure required -3+ years of clinical practice experience required -Case Management in an integrated model preferred -Bilingual preferred Additional Job Information: Typical office working environment with productivity and quality expectationsWork requires the ability to perform close inspection of hand written and computer generated documents as well as a PC monitor.Sedentary work involving periods of sitting, talking, listening. Work requires sitting for extended periods, talking on the telephone and typing on the computer.Ability to multitask, prioritize and effectively adapt to a fast paced changing environmentPosition requires proficiency with computer skills which includes navigating multiple systems and keyboardingEffective communication skills, both verbal and written. Required Skills: General Business - Communicating for Impact, Leadership - Collaborating for Results Desired Skills: Benefits Management - Encouraging Wellness and Prevention, General Business - Communicating for Impact, General Business - Demonstrating Business and Industry Acumen Functional Skills: Communication - Member communications, Communication - Provider communications Technology Experience: Aetna Application - Aetna Total clinical View Education: Nursing - Registered Nurse Potential Telework Position: No Percent of Travel Required: 0 - 10% EEO Statement: Aetna is an Equal Opportunity, Affirmative Action Employer 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 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.

Aetna Description: Utilizes advanced clinical judgment and critical thinking skills to facilitate appropriate member physical health and behavioral healthcare through assessment and care planning, direct provider coordination/collaboration, and coordination of psychosocial. This position is onsite only. Schedule is normal business hours and 1 late night 10:30am-7pm your choice. No weekends and no holidays. 59448 Fundamental Components: Assessment of Members: Through the use of clinical tools and information/data review, conducts comprehensive assessments of referred member's needs/eligibility and determines approach to case resolution and/or meeting needs by evaluating member's benefit plan and available internal and external programs/services. - Applies clinical judgment to the incorporation of strategies designed to reduce risk factors and address complex clinical indicators which impact care planning and resolution of member issues. - Using advanced clinical skills, performs crisis intervention with members experiencing a behavioral health or medical crisis and refers them to the appropriate clinical providers for thorough assessment and treatment, as clinically indicated. Provides crisis follow up to members to help ensure they are receiving the appropriate treatment/services. Enhancement of Medical Appropriateness and Quality of Care: - Application and/or interpretation of applicable criteria and clinical guidelines, standardized case management plans, policies, procedures, and regulatory standards while assessing benefits and/or member's needs to ensure appropriate administration of benefits - Using holistic approach consults with supervisors, Medical Directors and/or other programs to overcome barriers to meeting goals and objectives; presents cases at case conferences to obtain multidisciplinary view in order to achieve optimal outcomes - Identifies and escalates quality of care issues through established channels -Ability to speak to medical and behavioral health professionals to influence appropriate member care. - Utilizes influencing/motivational interviewing skills to ensure maximum member engagement and promotes 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 -Analyzes all utilization, self-report and clinical data available to consolidate information and begin to identify comprehensive member needs. Monitoring, Evaluation and Documentation of Care: -In collaboration with the member and their care team develops and monitors established plans of care to meet the member's goals -Utilizes case management and quality management processes in compliance with regulatory and accreditation guidelines and company policies and procedures. Background Experience: 3 years of direct clinical practice experience post masters degree, e.g., hospital setting or alternative care setting such as ambulatory care or outpatient clinic/facility Crisis intervention skills preferred Managed care/utilization review experience preferred Case management and discharge planning experience preferred EDUCATION Minimum of a Master's degree in Behavioral/Mental Health or related field LICENSE Unencumbered Behavioral Health clinical license in the state where they work and must be independently licensed.(LISW, LPCC, Licensed Psychologist) Additional Job Information: Candidate must be independently licensed in the state in which they will be working Requires knowledge of mental health and substance abuse disorders Must be able to talk on the telephone and type at the same time Experience using Motivational Interviewing and good technological skills are a plus Required Skills: Benefits Management - Encouraging Wellness and Prevention, Benefits Management - Understanding Clinical Impacts, General Business - Applying Reasoned Judgment Desired Skills: General Business - Communicating for Impact, Leadership - Collaborating for Results, Technology - Leveraging Technology Functional Skills: Clinical / Medical - Concurrent review / discharge planning, Clinical / Medical - Direct patient care (hospital, private practice), Clinical / Medical - Disease management, Medical Management - Medical Management - Clinical coverage and policies, Medical Management - Medical Management - Direct patient care Technology Experience: Aetna Application - Aetna Total clinical View, Desktop Tool - Microsoft Outlook, Desktop Tool - Microsoft Word Education: Mental Health - Licensed Clinical Social Worker, Mental Health - Licensed Independent Social Worker, Mental Health - Licensed Professional Counselor, Mental Health - Licensed Psychologist Potential Telework Position: No Percent of Travel Required: 0 - 10% EEO Statement: Aetna is an Equal Opportunity, Affirmative Action Employer 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

Aetna Description: Support comprehensive coordination of medical services including Care Team intake, screening and supporting the implementation of care plans to promote effective utilization of healthcare services. Promotes/supports quality effectiveness of Healthcare Services. 63919 Fundamental Components: Responsible for initial review and triage of Care Team tasks. Identifies principle reason for admission, facility, and member product to correctly apply intervention assessment tools. Screens patients using targeted intervention business rules and processes to identify needed medical services, make appropriate referrals to medical services staff and coordinate the required services in accordance with the benefit plan. Monitors non-targeted cases for entry of appropriate discharge date and disposition. Identifies and refers outlier cases (e.g., Length of Stay) to clinical staff. Identifies triggers for referral into Aetna's Case Management, Disease Management, Mixed Services, and other Specialty Programs. Utilizes eTUMS and other Aetna systems to build, research and enter member information, as needed. Support the Development and Implementation of Care Plans. Coordinates and arranges for health care service delivery under the direction of nurse or medical director in the most appropriate setting at the most appropriate expense by identifying opportunities for the patient to utilize participating providers and services Promotes communication, both internally and externally to enhance effectiveness of medical management services (e.g.,health care providers, and health care team members respectively) Performs non-medical research pertinent to the establishment, maintenance and closure of open cases Provides support services to team members by answering telephone calls, taking messages, researching information and assisting in solving problems. Adheres to Compliance with PM Policies and Regulatory Standards. Maintains accurate and complete documentation of required information that meets risk management, regulatory, and accreditation requirements. Protects the confidentiality of member information and adheres to company policies regarding confidentiality.May assist in the research and resolution of claims payment issues. Supports the administration of the hospital care, case management and quality management processes in compliance with various laws and regulations, URAQ and/or NCQA standards, Case Management Society of America (CMSA) standards where applicable, while adhering to company policy and procedures. Background Experience: 2-4 years experience as a medical assistant, office assistant. High School Diploma or G.E.D. 2-4 years experience in customer service / call center environment. Additional Job Information: Effective communication, telephonic and organization skills. Familiarity with basic medical terminology and concepts used in care management. Strong customer service skills to coordinate service delivery including attention to customers, sensitivity to issues, proactive identification and resolution of issues to promote positive outcomes for members. Computer literacy in order to navigate through internal/external computer systems, including Excel and Microsoft Word. Ability to effectively participate in a multi-disciplinary team including internal and external participants. Required Skills: Service - Handling Service Challenges, Service - Providing Solutions to Constituent Needs, Service - Working Across Boundaries Desired Skills: General Business - Communicating for Impact Functional Skills: Customer Service - Call center monitoring & analysis - Inbound calls - call center location Technology Experience: Desktop Tool - Microsoft Outlook Potential Telework Position: No Percent of Travel Required: 0 - 10% EEO Statement: Aetna is an Equal Opportunity, Affirmative Action Employer 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 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.

Walgreens Overview Our pharmacy technician positions have undergone an exciting transformation, moving from a transaction-based environment to a much more patient-centric one. As a Walgreens pharmacy technician, you'll be front and center - interacting with our customers and developing strong patient relationships. Pharmacy is the core of our business, and our pharmacy technicians enjoy all the tools and support - including the latest technology - to grow their careers and reach their goals. Responsibilities In accordance with state and federal regulations, assists the pharmacist, under direct supervision, in the practice of pharmacy. Assists the pharmacist in the performance of other Pharmacy Department duties in accordance with Company policies and procedures. Responsible for using pharmacy systems to obtain patient and drug information and process prescriptions. If PTCB certified, assists with and coaches pharmacy technicians in the operation of pharmacy systems and cashiers in the operation of the pharmacy cash registers. Models and delivers a distinctive and delightful customer experience. Customer Experience Engages customers and patients by greeting them and offering assistance with products and services. Resolves customer issues and answers questions to ensure a positive customer experience. Models and shares customer service best practices with all team members to deliver a distinctive and delightful customer experience, including interpersonal habits (e.g., greeting, eye contact, courtesy, etc.) and Walgreens service traits (e.g., offering help proactively, identifying needs, servicing until satisfied, etc.). Develops strong relationships with most valuable customers. Operations Under the supervision by the pharmacist, assist in the practice of pharmacy, in accordance with state, federal, and company policy. Reviews and complies with the Walgreen Co. Pharmacy Code of Conduct. Performs duties as assigned by Pharmacy Manager, Staff Pharmacist and Store Manager including utilizing pharmacy systems to enter patient and drug information, ensuring information is entered correctly, filling prescriptions by retrieving, counting and pouring pharmaceutical drugs, verifying medicine is correct, and checking for possible interactions. Assists pharmacists in scheduling and maintaining work flow. Reports, immediately, prescription errors to pharmacist on duty and adheres to Company policies and procedures in relation to pharmacy errors and the Quality Improvement Program. Strictly adheres to the Walgreen Co. policy regarding Good Faith Dispensing during all applicable prescription dispensing activities. Responsible and accountable for registering all related sales on assigned cash register, collects and handles cash as required. Takes customer to OTC aisle when possible to assist in locating products. Handles telephone calls that do not require personal attention of the pharmacist, including those to physicians. Processes (corrects and resubmits) manual claims for third party program prescription services in a timely and efficient manner, and performs other clerical duties, as assigned by the Pharmacy Manager. Assists and supports Pharmacy Department on inventory management activities, such as, ordering, unpacking, checking and storing shipment of pharmaceuticals. Maintains knowledge of Company asset protection techniques, and files claims for warehouse overages (merchandise received, but not billed), shortages (merchandise billed, but not received), order errors or damaged goods involving Rx drugs. May assist pharmacist in administering clinical services including the collection and proper labeling of blood/urine samples from patients and other clinical services as required; assists pharmacy staff in coordination of clinical services, Walgreens healthcare clinics and external providers. Assists Pharmacy Manager and Staff Pharmacist in developing and maintaining good relationships with the local medical community, including physicians, nurses, and other health care providers, by medical provider detailing and outreach to health groups, retirement homes, nursing homes, and other forums for enhancing growth opportunities. Assists with exterior and interior maintenance by ensuring the Pharmacy Department is stocked with adequate supplies, clean, neat and orderly in condition and appearance. Complies with all company policies and procedures; maintains respectful relationships with coworkers. Completes special assignments and other tasks as assigned. Training & Personal Development Earns and maintains PTCB certification through the designated PTCB training program and/or state required certification/registration. Otherwise, earns PTCB certification as condition of promotion to senior technician. Attends training and completes PPLs requested by Manager and acquires continuing education credits. Maintains knowledge and skill in healthcare and pharmacy, including latest news and developments.

Walgreens Overview Our pharmacy technician positions have undergone an exciting transformation, moving from a transaction-based environment to a much more patient-centric one. As a Walgreens pharmacy technician, you'll be front and center - interacting with our customers and developing strong patient relationships. Pharmacy is the core of our business, and our pharmacy technicians enjoy all the tools and support - including the latest technology - to grow their careers and reach their goals. Responsibilities In accordance with state and federal regulations, assists the pharmacist, under direct supervision, in the practice of pharmacy. Assists the pharmacist in the performance of other Pharmacy Department duties in accordance with Company policies and procedures. Responsible for using pharmacy systems to obtain patient and drug information and process prescriptions. If PTCB certified, assists with and coaches pharmacy technicians in the operation of pharmacy systems and cashiers in the operation of the pharmacy cash registers. Models and delivers a distinctive and delightful customer experience. Customer Experience Engages customers and patients by greeting them and offering assistance with products and services. Resolves customer issues and answers questions to ensure a positive customer experience. Models and shares customer service best practices with all team members to deliver a distinctive and delightful customer experience, including interpersonal habits (e.g., greeting, eye contact, courtesy, etc.) and Walgreens service traits (e.g., offering help proactively, identifying needs, servicing until satisfied, etc.). Develops strong relationships with most valuable customers. Operations Under the supervision by the pharmacist, assist in the practice of pharmacy, in accordance with state, federal, and company policy. Reviews and complies with the Walgreen Co. Pharmacy Code of Conduct. Performs duties as assigned by Pharmacy Manager, Staff Pharmacist and Store Manager including utilizing pharmacy systems to enter patient and drug information, ensuring information is entered correctly, filling prescriptions by retrieving, counting and pouring pharmaceutical drugs, verifying medicine is correct, and checking for possible interactions. Assists pharmacists in scheduling and maintaining work flow. Reports, immediately, prescription errors to pharmacist on duty and adheres to Company policies and procedures in relation to pharmacy errors and the Quality Improvement Program. Strictly adheres to the Walgreen Co. policy regarding Good Faith Dispensing during all applicable prescription dispensing activities. Responsible and accountable for registering all related sales on assigned cash register, collects and handles cash as required. Takes customer to OTC aisle when possible to assist in locating products. Handles telephone calls that do not require personal attention of the pharmacist, including those to physicians. Processes (corrects and resubmits) manual claims for third party program prescription services in a timely and efficient manner, and performs other clerical duties, as assigned by the Pharmacy Manager. Assists and supports Pharmacy Department on inventory management activities, such as, ordering, unpacking, checking and storing shipment of pharmaceuticals. Maintains knowledge of Company asset protection techniques, and files claims for warehouse overages (merchandise received, but not billed), shortages (merchandise billed, but not received), order errors or damaged goods involving Rx drugs. May assist pharmacist in administering clinical services including the collection and proper labeling of blood/urine samples from patients and other clinical services as required; assists pharmacy staff in coordination of clinical services, Walgreens healthcare clinics and external providers. Assists Pharmacy Manager and Staff Pharmacist in developing and maintaining good relationships with the local medical community, including physicians, nurses, and other health care providers, by medical provider detailing and outreach to health groups, retirement homes, nursing homes, and other forums for enhancing growth opportunities. Assists with exterior and interior maintenance by ensuring the Pharmacy Department is stocked with adequate supplies, clean, neat and orderly in condition and appearance. Complies with all company policies and procedures; maintains respectful relationships with coworkers. Completes special assignments and other tasks as assigned. Training & Personal Development Earns and maintains PTCB certification through the designated PTCB training program and/or state required certification/registration. Otherwise, earns PTCB certification as condition of promotion to senior technician. Attends training and completes PPLs requested by Manager and acquires continuing education credits. Maintains knowledge and skill in healthcare and pharmacy, including latest news and developments.

Aetna Description: This role is office based in New Albany, OH The hours are Monday-Friday 8:00am-4:30pm EST with evening shift rotation 4-5 times per month. Nurse Case Manager is responsible for telephonically and/or face to face assessing, planning, implementing and coordinating all case management activities with members to evaluate the medical needs of the member to facilitate the member's overall wellness. Develops a proactive course of action to address issues presented to enhance the short and long-term outcomes as well as opportunities to enhance a member's overall wellness through integration. Services strategies policies and programs are comprised of network management and clinical coverage policies. 63833 Fundamental Components: Through the use of clinical tools and information/data review, conducts an evaluation of member's needs and benefit plan eligibility and facilitates integrative functions as well as smooth transition to Aetna programs and plans. Applies clinical judgment to the incorporation of strategies designed to reduce risk factors and barriers and address complex health and social indicators which impact care planning and resolution of member issues. Assessments take into account information from various sources to address all conditions including co-morbid and multiple diagnoses that impact functionality. Reviews prior claims to address potential impact on current case management and eligibility. Assessments include the member's level of work capacity and related restrictions/limitations. Using a holistic approach assess the need for a referral to clinical resources for assistance in determining functionality. Consults with supervisor and others in overcoming barriers in meeting goals and objectives, presents cases at case conferences for multidisciplinary focus to benefit overall claim management. Utilizes case management processes in compliance with regulatory and company policies and procedures. Utilizes interviewing skills to ensure maximum member engagement and discern their health status and health needs based on key questions and conversation. Background Experience: -RN with current unrestricted state licensure required -3+ years clinical practice experience required -Case Management in an integrated model preferred -Bilingual preferred Additional Job Information: Typical office working environment with productivity and quality expectationsWork requires the ability to perform close inspection of hand written and computer generated documents as well as a PC monitor.Sedentary work involving periods of sitting, talking, listening. Work requires sitting for extended periods, talking on the telephone and typing on the computer.Ability to multitask, prioritize and effectively adapt to a fast paced changing environmentPosition requires proficiency with computer skills which includes navigating multiple systems and keyboardingEffective communication skills, both verbal and written. Required Skills: General Business - Communicating for Impact Desired Skills: Benefits Management - Maximizing Healthcare Quality Functional Skills: Nursing - Case Management, Nursing - Concurrent Review/discharge planning Technology Experience: Aetna Application - Aetna Total clinical View, Desktop Tool - Microsoft Outlook, Desktop Tool - Microsoft Word Education: Nursing - Registered Nurse Potential Telework Position: No Percent of Travel Required: 0 - 10% EEO Statement: Aetna is an Equal Opportunity, Affirmative Action Employer 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 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.

Aetna Description: Experienced compliance position that applies compliance, regulatory, business, analytical and communication skills to support, manage and help develop Medicare and Medicaid compliance programs and processes that promote compliant and ethical behavior, meet regulatory obligations and prevent, detect and mitigate compliance risks. 60999 Fundamental Components: Independently demonstrates the principles of effective Medicare and Medicaid Compliance programs, including, but not limited to, risk assessment, auditing and monitoring, maintaining effective policies and procedures, effective communication and training, identifying solutions to compliance gaps and helping business to implement compliance controls. Assists in the preparation and filing of moderately complex regulatory reports, non-product filings and follow-ups, and supports regulatory review and audit activities. Manages multiple moderately complex regulatory interactions including drafting regulatory correspondence, meeting with regulators and industry groups on compliance with laws and regulations, and responding to routine regulatory inquiries requiring an understanding of business processes and regulatory requirements. Supports compliance officers and moderately complex compliance business process reviews, corrective actions and other projects involving internal and external constituents. Independently develops materials that meet regulatory and legal requirements. Maintains positive, productive relationships with internal and external constituents and effectively communicates and influences decision-making and ethical and compliant outcomes at various levels necessary to accomplish goals. Appropriately escalates issues requiring resolution. Applies industry and compliance knowledge to support and manage moderately complex matters involving established compliance system and operations, including processes for implementation of laws and regulations, supports the Company's Privacy Office on privacy matters monitoring of compliance issues, and handling of moderately complex complaints. Independently identifies and assesses moderately complex compliance issues and risks that need resolution using established rules, regulations and guidelines, assists in the development of appropriate action plans and communications, monitors remediation and risk mitigation activity and appropriately informs and escalates matters to managers and subject matter experts. Independently collects the facts related to an issue, performs analysis and effectively prepares and communicates concise summaries on moderately complex matters. Responds to moderately complex requests for information within area of responsibility from internal and external constituents. Acts as resource for colleagues and effectively guides less experienced team members to accomplish goals. Ability to work independently and as part of a team. Background Experience: 3-5 years' experience in a regulatory compliance position in healthcare, with Medicare and Medicaid experience preferred, or relevant work experience in a business area. Project Management skills Bachelor's degree or equivalent experience. Required Skills: General Business - Consulting for Solutions, Leadership - Collaborating for Results, Service - Demonstrating Service Discipline Potential Telework Position: No Percent of Travel Required: 0 - 10% EEO Statement: Aetna is an Equal Opportunity, Affirmative Action Employer 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 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.