Firm Name: Aetna

Numbers of Jobs: Case Manager

Education Need: Graduate

Job Hours: 8

Payment: $20-$30/Hour

What's Job City: Chicago

Job Details:

This telework position is open to applicants from the Illinois counties of Henry and Rock Island. Up to 75% of the travel for this job will take place inside the designated region.

 Summary of programming.

 Join the Aetna team as an industry leader in serving dual eligible populations by utilizing best-in-class operating and clinical models, and help us elevate patient care to a new level. You have the power to significantly impact the lives of our members who are enrolled in Medicaid and Medicare and who deal with a wide range of challenging social and medical issues. To address the full range of our members' health care and social determinant needs, we collaborate with members, service providers, and neighborhood organizations. Our approach is one of compassion and effective communication. Join us in this exciting opportunity as we expand and grow to transform lives in new markets across the country.

 A statement of the family's goals.

 Facilitating the delivery of appropriate benefits and/or healthcare information that establishes eligibility for benefits while promoting wellness activities. Develops,

 implements, and supports health-related policies, plans, strategies, and initiatives that ensure the delivery of benefits, advance overall member wellness, and speed up the successful return to work. Services, strategies, and programs are made up of clinical coverage, network management, and policies.

 Mission Statement/Resume for the Position.

 Our case managers work together to evaluate, assess, plan, facilitate, coordinate care, and advocate for options and services to meet an individual's and family's total health needs through communication and available resources.

 promote cost-effective results of high quality.

 physical requirements and basic elements.

 • Acts as a point of contact for members, clients, families, employers, providers, insurance providers, and medical staff as required.

 • Executes and coordinates all case management tasks related to catastrophic cases and chronically ill patients across the continuum of care, which may include referring patients to consultants, sending caregivers to their homes, using community resources, and seeking out alternative levels of care.

 • Communicates with members or clients over the phone or in person. It might be necessary to travel to members' or clients' residences, places of employment, or medical facilities to provide ongoing case management services.

 • Evaluates and analyze the medical and/or vocational status of injured, recently ill, or chronically ill members and clients; develop a plan of care to facilitate the member's or client's appropriate condition management to maximize wellness and medical outcomes; enable a prompt return to work or optimal functioning; and determines eligibility for benefits as necessary.

 • Informs members, clients, and other stakeholders of relevant information (e.g., lawyers, employers, and insurance companies) by phone or in person.

 • When necessary, creates all casework activity documentation.

 • Consults with the internal multidisciplinary team when necessary to help the member or client get the best results in terms of their health.

 • To discuss the suggested course of action and course of treatment, you may, if necessary, contact the treating physician or other specialists.

 • Provides suggestions for prevention and education to ensure the best possible medical outcomes.

 • Adheres to all applicable laws and regulations governing the provision of rehabilitation services, as well as any special requirements imposed by particular insurance providers and referral sources.

 • Using clinical tools, information, and data, assesses members' and clients' needs, determines whether they qualify for benefits under the plan, and supports integrative activities.

 • Utilizes case management strategies by corporate guidelines and legal requirements.

 • Encourages optimal condition management, appropriate and prompt return to baseline, and optimal function or return to health.

 work.

 • Develops a proactive plan of action to address problems raised to enhance immediate and long-term outcomes as well as chances to enhance a member's or client's overall wellness through integration.

 • Measuring and assessing a member's or client's progress toward the intended results.

 Besides getting paid well, benefit from working for a company that cares about its staff and the community. The Company offers a wide range of health, dental, and vision benefits. The Company provides a 401(k) retirement savings plan in addition to the Employee Stock Purchase Plan, which is also accessible to qualified employees. In addition to fully paid term life insurance, the Company provides eligible employees with short- and long-term disability benefits. Furthermore, CVS Health offers a variety of wellness programs, educational support, free development courses, a discount at CVS stores, and partner discount schemes. All year long, paid holidays and Paid Time Off (PTO) or vacation pay is available to Company employees. According to state laws that are in force as well as company policies, paid holidays, sick days, and other vacation days are offered.

 Visit to discover more information about the advantages that are provided.

 jobs. benefits at cvshealth.com.

 Required credentials.

 - Residents of Illinois must possess a current, unrestricted RN license.

 - A minimum of three plus years' worth of clinical experience.

 - Able and ready to travel up to 75% of the time within Rock Island and Henry Counties in Illinois for in-person case management tasks as directed by leadership or as business needs dictate. It is essential to have dependable transportation. The company pays for mileage through its expense reimbursement policy.

 COVID requirements.

 Immunization Requirement for COVID-19.

 Where permitted by law, CVS Health requires certain coworkers to receive the full COVID-19 vaccination (including any booster shots that may be required), unless they are approved for a reasonable accommodation based on a disability, medical condition, religious conviction, or other legally recognized factors that prevent them from receiving the vaccination.

 You must submit an application for a reasonable accommodation within the first 10 days of employment, present proof of your immunization history, and have received at least one COVID-19 shot before beginning your job. Additionally, before starting work, you must present documentation of your vaccination history. Please be aware that before you can begin actively working, some roles and states may require you to show proof of a complete vaccination schedule or a reasonable accommodation that has been approved.

 Preferred qualifications.

 • At least two years of case management, discharge planning, or management of home health care experience.

 • A case manager with certification.

 Education.

•  Preferably a BSN or an associate's degree.