Jul 11, 2020

Case Management Coordinator Tampa

  • Professional Diversity Network
  • Tampa, FL, USA
Contractor Nurse

Job Description

Aetna

Description: 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.Schedule is Monday - Friday standard business. No nights, no weekends and no holidays. Region Tampa, FL metro.71615 Fundamental Components: - Conducts comprehensive evaluation of Members using care management tools and information/data review- Coordinates and implements assigned care plan activities and monitors care plan progress- Conducts 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 member's 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 knowledgeably participate with their provider in healthcare decision-makingMonitoring, 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: -2+ years of case management experience required - Long term care experience preferred-2+ years experience in social services preferred-Managed Care experience preferred-Bilingual Spanish/Haitian Creole preferred-Proficient MS Office-Unrestricted Florida driver's license in good standingEDUCATION-Bachelor's degree or non-licensed master level clinician required Additional Job Information: Case Manager will have a mixed caseload consisting of home, Assisted Living Facilities and Nursing Home members. State contract requires each member to receive monthly telephonic contact and face to face visits every 90 calendar days. The case Manager will travel 50 - 75% of the time to meet with Members and care team members in homes and facilities. The Long Term Care Case Manager is responsible for completing all required case file tasks including but not limited to: completion of 701B psycho-social assessments, care plan development, clear and complete case note documentation, coordination of services and benefits, referrals to clinical interventions and community resources, caregiver support and ongoing case management. Clinical Licensure: N/A Potential Telework Position: Yes Percent of Travel Required: 50 - 75% EEO Statement: Aetna is an Equal Opportunity, Affirmative Action Employer Benefit Eligibility: Benefit eligibility may vary by 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.PDN-71615BR

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