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Position Summary – Case Manager Analyst - Field

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.

Responsibilities:

• Facilitate appropriate healthcare outcomes for waiver/LTSS members by providing care coordination, support and education for members through the use of care management tools and resources.
• Evaluate members’ needs/eligibility and recommend an approach to case resolution and/or meeting needs by evaluating member’s benefit plan and available internal and external programs/services.
• Identify high risk factors and service needs that may impact member outcomes and care planning components with appropriate referral to clinical case management or crisis intervention as appropriate.
• Coordinate and implement assigned care plan activities and monitor care plan progress.
• Enhance medical appropriateness and quality of care by consulting with case managers, supervisors, Medical Directors and/or other health programs.
• Monitor, evaluate and document care in compliance with regulatory and accreditation guidelines and company policies and procedures.

Requirements:

• Must reside in the state of Illinois in the west side of Chicago area
• Valid Illinois Driver’s license
• Reliable transportation and willingness to travel up to 75% of the time
• Minimum of two (2) years of case management experience
• Microsoft Office and electronic health record experience

Preferred Qualifications:

• Case management and discharge planning experience
• Managed Care experience
• Microsoft Office experience
• Experience working with HIV and AIDS population
• Multi-lingual language proficiency

Education:

• Bachelor’s degree or a non-licensed individual with a master’s degree, with either degree being in a human-services field

Benefits:

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

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