Remote Case Manager RN, Texas

✨ About The Role

- The Case Manager RN will be responsible for assessing, planning, implementing, and coordinating all case management activities with members to evaluate their medical needs - The role involves conducting evaluations of member's needs, benefit plan eligibility, and facilitating integrative functions for smooth transitions to Aetna programs - The Case Manager RN will apply clinical judgment to incorporate strategies to reduce risk factors and barriers affecting care planning - Responsibilities include reviewing prior claims, assessing work capacity, and determining functionality for referrals to clinical resources - The position requires compliance with regulatory and company policies, as well as utilizing case management processes to enhance member wellness through integration

⚡ Requirements

- Must have an active and unrestricted RN multi-state licensure in Texas - Experience in clinical practice as an RN for at least 3 years is required - Proficiency in using multiple computer systems and applications including Microsoft Word, Excel, and Outlook - Ability to work within a team and independently to address complex health and social indicators impacting care planning - Strong communication skills to engage with members and assess their health needs effectively