This Case Management Analyst Field position is with Aetna's Long-Term Services & Supports (LTSS) team and is a field-based position out of the west side of Chicago area of Illinois. The requirement is for candidates to travel 50-75% of the time to meet with members face to face. This position holds a full caseload to manage waiver members. This position requires in-person quarterly visits with members.

Responsibilities:

• Evaluate members' needs and eligibility, and recommend approaches to case resolution
• Identify high-risk factors and service needs that may impact member outcomes and care planning
• Coordinate and implement assigned care plan activities and monitor care plan progress
• Utilize care management tools and resources to facilitate healthcare outcomes for waiver/LTSS members
• Provide care coordination, support, and education for members

Requirements:

• Minimum of two (2) years of case management experience
• Valid Illinois Driver's license
• Reliable transportation and willingness to travel up to 75% of the time
• Microsoft Office and electronic health record experience
• Bachelor's degree or non-licensed master's degree in a human-services field

Benefits:

• Comprehensive benefits package, including medical, dental, and vision coverage
• Paid time off
• Retirement savings options
• Wellness programs

Pay Range: $21.10 - $44.99 per hour

Job Data by YubHub.

As a Case Management Coordinator, you will facilitate appropriate healthcare outcomes for members by providing care coordination, support, and education through care management tools and resources.

Responsibilities:

• Conduct comprehensive evaluations of referred members' needs and eligibility using care management tools and data review.
• Recommend approaches to case resolution and meet needs by evaluating members' benefit plans and available internal and external programs/services.
• Identify high-risk factors and service needs that impact member outcomes and care planning.
• Coordinate and implement assigned care plan activities and monitor progress.
• Consult with case managers, supervisors, Medical Directors, and other health programs to overcome barriers to meeting goals.
• Identify and escalate quality of care issues through established channels.
• Utilize negotiation and motivational interviewing skills to secure appropriate options and services.
• Provide coaching, information, and support to empower members to make independent medical and healthy lifestyle choices.
• Help members participate actively in healthcare decision-making with their providers.
• Utilize case management and quality management processes in compliance with regulatory and accreditation guidelines.

Requirements:

• Reside in Illinois, specifically St. Clair County or surrounding areas.
• Valid Illinois Driver's license.
• Reliable transportation and willingness to travel up to 75% of the time.
• Minimum of two years of case management experience.
• Experience with Microsoft Office and electronic health records.

Preferred Qualifications:

• Case management and discharge planning experience.
• Managed Care experience.
• Microsoft Office experience.

Education:

• Bachelor's degree or non-licensed individual's master's degree in a human-services field.

Anticipated Weekly Hours:

• 40 hours per week.

Time Type:

• Full-time.

Pay Range:

• $21.10 - $44.99.

Benefits:

• Comprehensive benefits package including medical, dental, and vision coverage, paid time off, retirement savings options, and wellness programs.

Job Data by YubHub.