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Director Aetna Case Management Jobs in Kentucky (NOW HIRING)

Behavioral Health Group

Case Manager

Berea, KY · On-site

$16.75 - $21.50/hr

... Program Director. Key Responsibilities: * Conduct regular drug abuse case management sessions. * Orient patients to treatment program operations and procedures. * Collect and assess social ...

Hire Velocity, LLC

Targeted Case Manager

Covington, KY · On-site

Must successfully complete case management training within 6 months of hire and annual continuing ... DIRECT SERVICES: 45% * Complete additional releases of information forms with the client, family ...

BrightSpring

Case Manager

Bowling Green, KY

... Director of Clinical Management to determine the Company's ability to meet them. * Completes all ... Contacts referral sources to advise them of case acceptance and provides information on the ...

Chnk Behavioral Health

Targeted Case Manager

Covington, KY · On-site

$39K - $44K/yr

Must successfully complete case management training within 6 months of hire and annual continuing ... DIRECT SERVICES: 45% * Complete additional releases of information forms with the client, family ...

BrightSpring Health Services

Case Manager

Benton, KY · On-site

$19 - $19.23/hr

... Director of Clinical Management to determine the Company's ability to meet them. * Completes all ... Contacts referral sources to advise them of case acceptance and provides information on the ...

StepStone Family & Youth Services

Case Manager

Benton, KY · On-site

$19 - $19.23/hr

... Director of Clinical Management to determine the Company's ability to meet them. * Completes all ... Contacts referral sources to advise them of case acceptance and provides information on the ...

BrightSpring

Case Manager

Benton, KY

$19.23/hr

... Director of Clinical Management to determine the Company's ability to meet them. * Completes all ... Contacts referral sources to advise them of case acceptance and provides information on the ...

Valeris

Executive Case Manager (Remote)

Lexington, KY · Remote

Inbound Call Management * Manages inbound calls as directed by the program-approved FAQs * Triage patients to internal or external resources as appropriate. * Personalized Case Management * Provides ...

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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:
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Director Aetna Case Management jobs near you
Case Manager Project Link Addictions

Case Manager Project Link Addictions

Seven Counties Services

Louisville, KY

$19.25 - $24.75/hr

Full-time

Posted 15 days ago

Seven Counties Services rating

6.1

Company rating: 6.1 out of 10

Based on 5 frontline employees who took The Breakroom Quiz

Job description


Job Description:

ESSENTIAL JOB FUNCTIONS

Conducts and documents comprehensive assessment of client and/or client's needs. Participates in development of client's service plan, consistent with assessment. Arranges for delivery of needed services, as identified in assessment. Assists client in accessing needed services through, for example, referrals or linkages. Monitors client's progress by making referrals, tracking client's appointments, performing follow-up on services rendered, and performing periodic reassessments of client's changing needs. Performs advocacy activities on behalf of client (e. g., writing letters to expedite entitlement payments, encouraging client or family members to advocate on own behalf). Prepares and maintains case records documenting contacts, services needed, reports, client's progress, etc., in accordance with SCS and regulatory standards. Provides case consultation (i. e., consulting with service providers/collaterals in determining client's status and progress). Communicates with supervisor about issues related to case management, resourcing, service collaboration, and development of new resources. Provides psychosocial education to clients and/or family members to increase their understanding of client's illness, physical condition, or social situation. Performs crisis assistance (i. e., intervention on behalf of client, making arrangements for emergency referrals, coordinates other needed emergency services). May serve as Primary Case Coordinator (PCC), with volume and complexity of PCC assignments depending on incumbent's skill and autonomy.

The intent of this job description is to provide a representative summary of the major duties and responsibilities performed by incumbents of this job. Incumbents may be requested to perform job-related tasks other than those specifically presented in this description.

EDUCATION

  • Bachelor's degree in Social Work, Psychology, Sociology, Human Services, or related field as approved by Medicaid, or as required by applicable funding source.
  • Completion of state-required case management/service coordination course within six months of date of employment.

EXPERIENCE

  • At least one (1) year of full-time employment experience post Bachelor's working directly with substance abuse population (with direct daily contact) in a human service setting, with relevant Master's degree, no experience.

**Education and experience requirements vary among programs. Candidates for employment, hiring managers, and incumbents should refer to program- or team-specific job descriptions for all education and experience requirements applicable to particular case management/service coordinator job classifications.

PHYSICAL DEMANDS/REQUIREMENTS

  • Position requires lifting of 20 pounds maximum, with frequent lifting and/or carrying of items weighing up to 10 pounds, or requires significant periods of walking or standing.
  • Frequent exposure to threat of bodily harm from clients or families.
  • Normal tasks may involve exposure to blood, bodily fluids, or tissue.
  • May involve 24-hour on-call responsibilities.
  • Reliable transportation for frequent travel.

Within the bounds of their respective job descriptions, all staff are expected to exercise principle-centered leadership, focused on customer service responsiveness, with a continuous quality improvement orientation. Additionally, all staff are expected to develop a working knowledge of and follow all policies and procedures related to safety management and other Joint Commission standards.

Time Type:

Full time

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