• Aetna
  • $60,680.00 -83,990.00/year*
  • New York, NY
  • Nonprofit
  • Full-Time
  • 21 Warren St

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Job Description

JOIN OUR GROWING TEAM

Are you tired of bedside nursing?

Are you looking to get away from 12-hour hospital shifts while continuing to utilize your RN expertise to impact the lives of patients in your local community?

We are seeking self-motivated, energetic, detail oriented, highly organized, tech-savvy Registered Nurses to join our Workers' Compensation Field Case Management team. This opportunity offers a competitive salary, full benefits, and a performance-based bonus paid out on a monthly or quarterly basis. Our organization promotes autonomy through a Monday-Friday working schedule, paid holidays, and flexibility as you coordinate the care of your members.

Position Summary/Mission

Travel 75% up to a 200 mile radius.

Territory Boroughs, i.e. Manhattan, Yonkers, Bronx, Brooklyn, Queens, Staten Island, Long Island.

Fundamental components not limited to the following:

Acts as a liaison with member/client /family, employer, provider(s), insurance companies, and healthcare personnel as appropriate.

Implements and coordinates all case management activities relating to catastrophic cases and chronically ill members/clients across the continuum of care that can include consultant referrals, home care visits, the use of community resources, and alternative levels of care.

Interacts with members/clients telephonically or in person. May be required to meet with members/clients in their homes, work-sites, or physician's office to provide ongoing case management services.

Assesses and analyzes injured, acute, or chronically ill members/clients medical and/or vocational status; develops a plan of care to facilitate the member/client's appropriate condition management to optimize wellness and medical outcomes, aid timely return to work or optimal functioning, and determination of eligibility for benefits as appropriate.

Communicates with member/client and other stakeholders as appropriate (e.g., medical providers, attorneys, employers and insurance carriers) telephonically or in person.

Prepares all required documentation of case work activities as appropriate.

Interacts and consults with internal multidisciplinary team as indicated to help member/client maximize best health outcomes.

May make outreach to treating physician or specialists concerning course of care and treatment as appropriate.

Provides educational and prevention information for best medical outcomes.

Applies all laws and regulations that apply to the provision of rehabilitation services; applies all special instructions required by individual insurance carriers and referral sources.

Testifies as required to substantiate any relevant case work or reports.

Conducts an evaluation of members/clients' needs and benefit plan eligibility and facilitates integrative functions using clinical tools and information/data.

Utilizes case management processes in compliance with regulatory and company policies and procedures.

Facilitates appropriate condition management, optimize overall wellness and medical outcomes, appropriate and timely return to baseline, and optimal function or return to work.

Develops a proactive course of action to address issues presented to enhance the short and long-term outcomes, as well as opportunities to enhance a member's/client's overall wellness through integration.

Monitors member/client progress toward desired outcomes through assessment and evaluation.

BACKGROUND/EXPERIENCE:

3 years case management experience.

5 years clinical practice experience.

Ability to travel within a designated geographic area for in-person case management activities

Bilingual Spanish preferred

Knowledge of laws and regulations governing delivery of rehabilitation services.

Job-specific technical knowledge, (e.g., knowledge of workers compensation and disability industry for workers compensation case managers or case management).

Excellent analytical and problem solving skills

Effective communications, organizational, and interpersonal skills.

Ability to work independently (may require working from home).

Proficiency with standard corporate software applications, including MS Word, Excel, Outlook and PowerPoint, as well as some special proprietary applications.

Effective computer skills including navigating multiple systems and keyboarding.

EDUCATION

The minimum level of education desired for candidates in this position is a Associate's degree or equivalent experience.

LICENSES AND CERTIFICATIONS

Nursing/Registered Nurse is required state of New York RN License active and unrestricted

FUNCTIONAL EXPERIENCES

Functional - Clinical / Medical/Direct patient care (hospital, private practice)/4-6 Years

Functional - Medical Management/Medical Management - Case Management/4-6 Years

Functional - Nursing/Medical-Surgical Care/4-6 Years

Functional - Nursing/Case Management/1-3 Years

TECHNOLOGY EXPERIENCES

Technical_Experience/Technical_Focus/1-3 Years/End User

Technical - Telecommunications//1-3 Years/End User

Telework Specifications:

Field Case Nurse (RN License required) Manager will work from home base, daily travel throughout NYC, 5 Boroughs, Long Island required.

ADDITIONAL JOB INFORMATION

No holidays or weekends required. Work independently in the field as a consultant with additional opportunity to earn a monthly bonus.

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.

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.

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.

All employees are expected to embody our values of Excellence, Integrity, Caring and Inspiration in all that they do as an employee. The overall responsibility of the Field Case Manager is to ensure the injured worker receives the best possible care in a timely and efficient manner towards full rehabilitation and return to work. Please note that we do offer mileage reimbursement for local travel.

As a Workers' Compensation Field Case Manager, you will be offered:

Autonomy

Productivity incentives

Monday-Friday schedule

Reimbursement for mileage, tolls, parking, licensure and certification

Laptop, iPhone & printer/fax/scanner all in one.

All major holidays are paid time off, vacation and sick time off is accrued. Full benefits offered including 401(k) and many corporate discounts available. Employees are reimbursed for fees to maintain licensure as well as free CEU's to maintain licensure. Continuing Education credits are available/provided for RN and a various industry certifications too. Work from home with in-state travel. In addition to annual salary, position has potential for a monthly monetary bonus.


Associated topics: case management, development manager, liaison, manage, office manager, project, program management, project development, project management, resource development

* The salary listed in the header is an estimate based on salary data for similar jobs in the same area. Salary or compensation data found in the job description is accurate.

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