Case Manager RN

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. Excellent benefits package, including 401k, tuition, licensure and certification reimbursement. We promote healthy & wellness lifestyles and offer specialty programs here at Aetna.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.Benefit eligibility may vary by position. Click here to review the benefits associated with this position.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. *JVS Job TitleCase Manager RN*Job DescriptionPOSITION SUMMARYThe RN Case Manager utilizes advanced clinical judgment and critical thinking skills to facilitate appropriate physical and behavioral healthcare and social services for members through assessment and member-centered care planning, direct provider coordination/collaboration, and coordination of psychosocial wraparound services to promote effective utilization of available resources, optimal member functioning, and cost-effective outcomes. Routine field based travel is required with personal vehicle.Qualified candidates must have an active RN license for the State of VA, dependable transportation, a valid and active VA driver's license and proof of vehicle insurance.Fundamental Components:Assessment of Members:-Through the use of clinical tools and review of member specific health information/data, conducts comprehensive assessments of referred members needs/eligibility and, in collaboration with the members care team, determines an approach to resolving member issues and/or meeting needs by evaluating the members benefit plan and available internal and external programs/services and resources.- Applies clinical judgment to the incorporation of strategies designed to reduce risk factors and barriers and address complex clinical indicators which impact care planning and resolution of member issues.- Using advanced clinical skills, performs crisis intervention with members experiencing behavioral health or medical crisis and refers them to the appropriate clinical and service 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 ...