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Director Aetna Case Management Jobs in Kentucky (NOW HIRING)

A Day in the Life The RN, Director of Case Management will be responsible for overseeing and advancing all case management functions within our organization. This role is pivotal in ensuring clients ...

Case Manager, Registered Nurse

Frankfort, KY · Remote

$54.10K - $155.54K/yr

American Health Holding, Inc (AHH) is a medical management company that is a division within Aetna ... Using a holistic approach, consults with clinical colleagues, supervisors, Medical Directors and/or ...

Case Manager

Columbia, KY · On-site

$17.25 - $22/hr

Case management or related human services experience. * Paid professional experience with aging and ... Direct experience working with individuals with disabilities or mental illness. * Assisting ...

... case management services they provide The Commitment House clients. The monthly payment will be ... Prior Authorization, Assurance Form, Needs Assessment, Treatment Plan, 4 monthly contacts (2 direct ...

... case management services they provide The Commitment House clients. The monthly payment will be ... Prior Authorization, Assurance Form, Needs Assessment, Treatment Plan, 4 monthly contacts (2 direct ...

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Director Aetna Case Management information

What are the key skills and qualifications needed to thrive as a Director of Aetna Case Management, and why are they important?

To succeed as a Director of Aetna Case Management, you typically need a bachelor's or master's degree in nursing or a related field, active RN licensure, and extensive experience in case management or care coordination. Familiarity with case management software, utilization review tools, and health plan systems such as Milliman or InterQual is essential. Outstanding leadership, strategic thinking, and effective communication skills set top performers apart in this role. These competencies are crucial for driving quality care outcomes, ensuring regulatory compliance, and leading teams in a complex managed care environment.

How does a Director of Aetna Case Management typically collaborate with clinical teams and other departments?

A Director of Aetna Case Management regularly works with interdisciplinary teams, including nurses, social workers, physicians, and administrative staff. They facilitate coordination between departments to ensure members receive comprehensive, timely care and to streamline case management processes. Effective communication and leadership are essential, as the director often leads meetings, sets care management strategies, and resolves complex cases that require input from multiple specialties. Collaboration also extends to working with external providers and vendors to optimize patient outcomes and resource utilization.

What does a Director of Aetna Case Management do?

A Director of Aetna Case Management oversees the case management operations within the organization, ensuring that patients receive appropriate, cost-effective care. They lead teams of case managers, develop and implement care coordination strategies, and ensure compliance with regulations and Aetna's policies. Their role involves collaborating with healthcare providers, monitoring program outcomes, and improving processes to enhance patient health and satisfaction. Additionally, they play a crucial part in managing budgets and aligning case management practices with organizational goals.

What is the difference between Director Aetna Case Management vs Case Manager Aetna?

AspectDirector Aetna Case ManagementCase Manager Aetna
CredentialsTypically requires RN, BSN, or related certifications; leadership experienceRN or relevant healthcare certification; less emphasis on leadership
Work EnvironmentOversees teams, manages programs, strategic planningDirect patient interactions, care coordination, documentation
Employer & Industry UsageUsed in health insurance companies like Aetna for leadership rolesCommon in healthcare settings and insurance companies for direct care roles

The main difference between Director Aetna Case Management and Case Manager Aetna lies in scope and responsibilities. The director oversees teams and strategic initiatives, requiring leadership experience, while the case manager focuses on direct patient care and care coordination. Both roles are integral to Aetna's healthcare management but differ significantly in seniority and scope.

What are the most commonly searched types of Aetna Case Management jobs in Kentucky? The most popular types of Aetna Case Management jobs in Kentucky are:
What are popular job titles related to Director Aetna Case Management jobs in Kentucky? For Director Aetna Case Management jobs in Kentucky, the most frequently searched job titles are:
What job categories do people searching Director Aetna Case Management jobs in Kentucky look for? The top searched job categories for Director Aetna Case Management jobs in Kentucky are:
Case Management Director

Case Management Director

Encompass Health Corporation

Louisville, KY • On-site

Full-time, Part-time

Medical, Dental, Vision, Retirement, PTO

Posted 22 days ago


Encompass Health rating

6.9

Company rating: 6.9 out of 10

Based on 403 frontline employees who took The Breakroom Quiz

449th of 864 rated healthcare providers


Job description

Job Description
Case Management Director Career Opportunity
Highly regarded for your Case Management Director expertise
Are you an experienced and compassionate healthcare professional with a background in case management, seeking a career that aligns with your professional expertise and resonates with your personal values? As the Director of Case Management at Encompass Health, you have the unique opportunity to lead a team and make a profound impact on the lives of individuals within your local community. This role combines fulfilling career opportunities close to home with the chance to make a meaningful difference in the well-being of those around you. Join us in this journey of care, compassion, and leadership as we work together to make a difference where it matters most, serving as a key member of our leadership team overseeing the day-to-day operations and management of our Case Management department.
A Glimpse into Our World
At Encompass Health, you'll experience the difference the moment you become a part of our team. Being at Encompass Health means aligning with a rapidly growing national inpatient rehabilitation leader. We take pride in the growth opportunities we offer and how our team unites for the greater good of our patients. Our achievements include being named one of the "World's Most Admired Companies" and receiving the Fortune 100 Best Companies to Work For® Award, among other accolades, which is nothing short of amazing.
Starting Perks and Benefits
At Encompass Health, we are committed to creating a supportive, inclusive, and caring environment where you can thrive. From day one, you will have access to:
• Affordable medical, dental, and vision plans for both full-time and part-time employees and their families.
• Generous paid time off that accrues over time.
• Opportunities for tuition reimbursement and continuing education.
• Company-matching 401(k) and employee stock purchase plans.
• Flexible spending and health savings accounts.
• A vibrant community of individuals passionate about the work they do!
Become the Case Management Director you've always aspired to be
• Assume responsibility for the day-to-day operations and human resource management of the Case Management department.
• Oversee the interdisciplinary plan of care and the discharge planning process to ensure the effectiveness and appropriateness of services with a central focus on census management, patient care outcomes, and key care indicators.
• Act as a patient and family advocate, ensuring that services are delivered to meet the needs of patients and their families.
• Provide guidance and support to Case Managers and other staff, including training on managing caseloads and interpreting regulations, policies, operational procedures, and objectives. Review operations to ensure a high level of quality consistent with organizational standards.
• Build relationships with insurance companies, self-insured employers, case management firms, and other healthcare networks.
• Celebrate the accomplishments and successes of our dedicated employees along the way.
Qualifications
• Current CCM® or ACMTM certification is preferred.
• Must be qualified to independently complete an assessment within the scope of practice of his/her discipline.
• If licensure is required for the discipline within the hospital's state, individual must hold an active license.
• For Nursing, must possess bachelor's degree in nursing (BSN) with RN licensure.
• For other eligible health care professionals, must possess a minimum of a bachelor's degree; a graduate degree is preferred.
• Three years of hospital-based Case Management experience, including Utilization Review and Discharge Planning experience.
• May be required to work weekdays and/or weekends, evenings and/or night shifts.
• May be required to work on religious and/or legal holidays on scheduled days/shifts.
#LI-CB1
About Us
The Encompass Health Way
We proudly set the standard in care by leading with empathy, doing what's right, focusing on the positive, and standing stronger together. Encompass Health is a trusted leader in post-acute care with over 150 nationwide locations and a team of 36,000 exceptional individuals and growing!
At Encompass Health, we celebrate and welcome diversity in our inclusive culture. We provide equal employment opportunities regardless of race, ethnicity, gender, sexual orientation, gender identity or expression, religion, national origin, color, creed, age, mental or physical disability, or any other protected classification.

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Encompass Health logo

About Encompass Health

Sourced by ZipRecruiter

Helping patients regain hope and independence, Encompass Health is a national leader in post-acute care. We operate rehabilitation hospitals in 36 states as well as Puerto Rico. Following the Encompass Way, we are driven by our core values: We proudly set the standard, lead with empathy, do what's right, focus on the positive, and remain stronger together.

Industry

Hospitals

Company size

10,000+ Employees

Headquarters location

Birmingham, AL, US

Year founded

1984