Aetna Clinical Care Manager in Louisville, Kentucky

Req ID: 42037BR

Position Summary

This position is responsible for behavioral health discharges and integrated telephonic case management.

Fundamental Components:

The Clinical Care Manager's primary responsibility will be completing discharge follow-up calls for Aetna Better Health of Kentucky members being discharged from behavioral health hospitals as required under the Medicaid Managed Care Organization contract with the state and outlined in HEDIS measures including coordination of services and assisting members locating behavioral health providers and other providers as appropriate. The position may also be required to perform telephonic case management activities to evaluate the medical and behavioral health needs of members of members including case formulation, identification of root causes and developing and updating care plans.

Background/Experience Required:

3-5 years of Clinical experience

Background/Experience Preferred:

  • Clinical experience in Behavioral Health

  • Managed Care experience (Case Management & Discharge Planning)

  • Certified Case Manager preferred (CCM)

  • Crisis intervention skills preferred

    Education:

    The minimum level of education required for candidates in this position is:

  • Associate's Degree in Nursing for a candidate with an active RN License

  • A Master's Degree for a candidate with a LCSW or LPCC

    Licenses/Certifications:

    One of the following licenses is required:

  • Registered Nurse License (RN)

  • Licensed Clinical Social Worker (LCSW)

  • Licensed Professional Clinical Counselor (LPCC)

    Certified Case Manager is desired (CCM)

    FUNCTIONAL EXPERIENCES

    Functional - Medical Management/Medical Management - Case Management/4-6 Years

    Functional - Clinical / Medical/Concurrent review / discharge planning/1-3 Years

    Functional - Medical Management/Medical Management - Managed Care/Insurance Clinical Staff/1-3 Years

    TECHNOLOGY EXPERIENCES

    Technical - Desktop Tools/Microsoft Outlook/1-3 Years/End User

    Technical - Desktop Tools/Microsoft Word/1-3 Years/End User

    Technical - Desktop Tools/Microsoft PowerPoint/1-3 Years/End User

    Telework Specifications:

    Office based position in the Louisville, KY office with option for telework that will be evaluated after a established period of employment and exceptable performance

    ADDITIONAL JOB INFORMATION

    No weekend and holidays and opportunity for growth

    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 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.

Job Function: Health Care