Aetna Careers Remote Data Entry – Work From Home Jobs
Industry: Private
Employment Type: Full Time
Work Hours: 8
Salary: $35 – $45Hour
Location: United States
Company: Aetna
Descriptions:
Aetna Careers Remote Data Entry – Work From Home Jobs
Aetna is as an industry leader in serving dual eligible populations by utilizing best-in-class operating and clinical models. We collaborate with members, providers, and community organizations in pursuit of quality solutions that address the full continuum of our members’ health care and social determinant needs. Dual Eligible Special Needs Plans (DSNP) members are enrolled in Medicare and Medicaid. Our Care Managers are frontline advocates for members who cannot advocate for themselves. Join us in this exciting opportunity as we grow and expand DSNP into new markets across the country.
Fundamental Components
- Nurse Care Manager is responsible for assessing, planning, implementing, and coordinating all case management activities with members to evaluate the medical needs of the member to facilitate the member’s overall wellness.
- Develops a proactive plan of care to address identified issues to enhance the short and long-term outcomes as well as opportunities to enhance a member’s overall wellness.
- Uses clinical tools and information/data review to conduct an evaluation of member’s needs and benefits.
- Applies clinical judgment to incorporate strategies designed to reduce risk factors and barriers and address complex health and social indicators which impact care planning.
- Conducts assessments that consider information from various sources, such as claims, to address all conditions including co-morbid and multiple diagnoses that impact functionality.
- Uses a holistic approach to assess the need for a referral to clinical resources and other interdisciplinary team members.
- Consults with supervisor and others in overcoming barriers in meeting goals and objectives, presents cases at interdisciplinary case conferences.
- Utilizes case management processes in compliance with regulatory and company policies and procedures. Utilizes motivational interviewing skills to ensure maximum member engagement and discern their health status and health needs based on key questions and conversation.
Required Experience
- Active and unrestricted RN licensure in the state of Florida OR compact RN licensure in state of residence
- Minimum 3+ years clinical practical experience
- Minimum 2+ years case management, discharge planning and/or home health care coordination experience
Preferred Experience
- Bilingual (English/Spanish)
- Certified Case Manager
- Excellent analytical and problem-solving skills
- Effective communications, organizational, and interpersonal skills.
- Ability to work independently
- Effective computer skills including navigating multiple systems and keyboarding
- Proficiency with standard corporate software applications, including MS Word, Excel, Outlook, and PowerPoint, as well as some special proprietary applications
Education and Certification Requirements
- Bachelor’s degree or minimum of an Associate’s degree with equivalent experience.
Aetna Careers Remote Data Entry – Work From Home Jobs
About the Aetna Company:
Aetna, a prominent name in the U.S. healthcare industry, has evolved into a comprehensive health benefits provider. Now a subsidiary of CVS Health, the company offers a wide range of health insurance plans and related services.
A Rich History
Founded as an insurance company in the 19th century, Aetna’s roots are deep in the American business landscape. Named after the active volcano Mount Etna, symbolizing strength and resilience, the company has mirrored that spirit in its operations. Over the decades, Aetna expanded its services beyond property insurance to encompass health insurance, becoming a major player in the managed care sector.
A Focus on Member Well-being
Aetna’s core mission is to help people live healthier lives. The company achieves this by offering a variety of health insurance plans tailored to individuals, families, and employers. These plans cover medical, dental, behavioral health, and pharmacy benefits. Beyond traditional insurance, Aetna also provides a range of programs and services aimed at preventive care, chronic disease management, and wellness initiatives.
The CVS Health Partnership
In a strategic move to enhance its healthcare offerings, Aetna merged with CVS Health in 2018. This partnership brought together a pharmacy giant and a leading health insurer, creating a powerful force in the industry. The combined entity aims to deliver more accessible, affordable, and effective healthcare solutions by integrating pharmacy, medical, and behavioral health services.
A Commitment to Innovation
Aetna is at the forefront of healthcare innovation. The company leverages technology to improve the member experience, streamline administrative processes, and enhance care delivery. From digital health tools to data analytics, Aetna is committed to finding new ways to improve health outcomes and lower costs.
Challenges and Opportunities
The healthcare industry is dynamic, marked by constant changes in regulations, technology, and consumer expectations. Aetna, like other major players, faces challenges such as rising healthcare costs, increasing competition, and the need to adapt to evolving consumer preferences. However, the company also enjoys significant opportunities to expand its market share, develop innovative products, and improve population health.
In conclusion, Aetna is a vital component of the U.S. healthcare system. With its rich history, extensive network, and focus on innovation, the company is well-positioned to continue serving the evolving needs of its members and customers. As part of CVS Health, Aetna is poised to play a pivotal role in shaping the future of healthcare in America.