Aetna Remote Jobs, Aetna Jobs Ohio @Jobsextraincome ( Case Management Coordinator )

Hiring Organization: Aetna

Post Name: Case Management Coordinator

Qualification: Graduate

Industry:  Private

Employment Type: Full Time

Work Hours: 8 Hours

Salary: $20-$30/Hour

Location: Tampa, FL

Full Jobs Description

The Case Management Coordinator is responsible for the assessment, planning, execution and coordination of all telephone case management activities with members to assess the member's medical needs to promote the member's overall well-being. Develops a proactive approach to solving presented problems to improve short-term and long-term outcomes, as well as opportunities to improve overall member well-being through integration. Service strategies policies and programs include network management and clinical coverage.

Aetna Remote Jobs, Aetna Jobs Ohio @Jobsextraincome ( Case Management Coordinator )

 Using clinical tools and data/information review, assesses member needs and benefit plan fit and facilitates integration activities and smooth transition to Aetna programs and plans. Uses clinical judgment to incorporate strategies designed to reduce risk factors and barriers and address health and social indicators that influence care planning and  member problem solving.

• The assessment takes into account information from various sources to address all conditions, including co-morbidities and diseases.
•  multiple diagnoses that affect functioning. Reviews previous claims to determine potential impact on current case management and eligibility. 
• Assessments include the member's level of work ability and associated limitations. Assess the need to direct clinical resources using a holistic approach  to assist in prescribing

 functionality

• Consults with regulatory agencies and others to overcome barriers to achieving goals and objectives, presents cases at case conferences on multidisciplinary topics to benefit overall claims management.
• Uses case management processes in accordance with regulations and company policies and procedures.
• Uses motivational interviewing skills to ensure maximum member engagement and determine their health status and health needs based on key questions and discussions.

Aetna Remote Jobs, Aetna Jobs Ohio @Jobsextraincome ( Case Management Coordinator )