Job Details

RN Field Case Manager (Registered Nurse) San Diego Spanish Speaking

Company name
Aetna Inc.

Location
San Diego, CA

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This is a full time Work-At-Home opportunity with 75% local daily travel in the field. Candidates should reside in the San Diego, CA area. You will be on the road 75% of your week! This does provide some flexibility! This role does require bi-lingual Spanish skills!

This role as a Field Case manager is a high initiative, challenging position that utilizes critical thinking and effective communication skills while working with injured workers, employers, claims examiners, attorneys, and treatment providers to improve patient outcomes. You will evaluate injured workers' medical and vocational needs to develop a specialized plan of care that promotes successful return to work while assisting in the coordination of therapeutic services. You will monitor injured workers' progress toward desired outcomes in a variety of environments, including the home, work site, and physician office settings.

This is an opportunity to make a positive impact in the life of an injured worker.

You will be responsible for assessing and analyzing an injured employee to evaluate the medical and vocational needs required to facilitate the patients appropriate and timely return to work. You have the opportunity to Act as a liaison with patient/family, employer, provider(s), insurance companies, and healthcare personnel.

Fundamental Components

Assesses and analyzes an injured employees medical and vocational status; develops a plan of care to facilitate the patients appropriate and timely return to work.

Interviews patients in their homes, work-sites, or physicians office to provide ongoing case management services.

Monitors patient progress toward desired outcomes through assessment and evaluation.

Communicates both in-person and telephonically with patient, medical providers, attorneys, employers and insurance carriers; prepares all required documentation of case work activities.

May arrange referrals, consultations and therapeutic services for patients; confers with specialists concerning course of care and treatment.

Develops and administers educational and prevention programs.

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.

Daily travel in the field.

BACKGROUND/EXPERIENCE

Registered Nurse (RN) with active state license in good standing in the state where job duties are performed.

Minimum 1-2 years clinical nursing background

Prior case management and workers' compensation experience preferred

Ability to multitask in a fast paced work environment

Strong computer skills with experience in Microsoft Office Products

Excellent communication skills

Spanish Bi-lingual skills are a requirement

EDUCATION

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

LICENSES AND CERTIFICATIONS

Nursing/Registered Nurse (RN) is required

Nursing/Certified Case Manager (CCM) is desired

FUNCTIONAL EXPERIENCES

Functional - Nursing/Case Management/1-3 Years

Functional - Nursing/Medical-Surgical Care/1-3 Years

ADDITIONAL JOB INFORMATION

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.

Company info

Aetna Inc.
Website : http://www.aetna.com

Company Profile
Aetna Inc. operates as a diversified health care benefits company in the United States. The company operates in three segments: Health Care, Group Insurance, and Large Case Pensions. The Health Care segment provides medical, pharmacy benefit management, dental, behavioral health, and vision plans on an insured basis, and an employer-funded or administrative basis. This segment also provides Medicare and Medicaid products and services, as well as other medical products, such as medical management and data analytics services, medical stop loss insurance, workers' compensation administrative services, and products that provide access to its provider networks in select markets. This segment offers its products and services to multi-site national, mid-sized, and small employers, as well as individual customers. The Group Insurance segment provides life insurance products comprising group term life insurance, voluntary spouse and dependent term life insurance, group universal life, and accidental death and dismemberment insurance; disability insurance products; and long-term care insurance products, which offer benefits to cover the cost of care in private home settings, adult day care, assisted living, or nursing facilities. This segment provides insurance products principally to employers that sponsor its products for the benefit of their employees and their employees’ dependents. The Large Case Pensions segment manages various retirement products, including pension and annuity products for tax-qualified pension plans. The company’s customers include employer groups, individuals, college students, part-time and hourly workers, health plans, health care providers, governmental units, government-sponsored plans, labor groups, and expatriates. Aetna Inc. was founded in 1853 and is headquartered in Hartford, Connecticut.

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