ZipRecruiter

Log In

1

Director Aetna Case Management Jobs (NOW HIRING)

Tenet Health

Director of Case Management

Memphis, TN · On-site

... Aetna. Saint Francis Hospital serves as an academic training site for University of Tennessee ... Experience: 3 years of acute hospital case management or healthcare leadership experience

InstantServe LLC

Director, Case Management

Houston, TX · On-site

The Director of Case Management is responsible and accountable for the implementation of the case management program at the local level. The components/roles of the inpatient case management program ...

OSI Recruit

Director, Case Management

Houston, TX

\n \n \n \n \n The Director of Case Management is responsible and accountable for the implementation of the case management program at the local level. The components\/roles of the inpatient case ...

HCTHealthcare

Director Case Management

Flagstaff, AZ

HCT is seeking an interim Director of Case Management for a 70+ bed hospital in Arizona. The responsibilities include: * Leading, supervising, managing, and coordinating multiple care coordination ...

HiredFirst

Director Case Management

Bradenton, FL · On-site

$109K - $164K/yr

A Director of Case Management opportunity is available in Bradenton, FL. This leadership role oversees all operational aspects of hospital case management, bringing executive-level direction to care ...

next page

Showing results 1-20

People also search for

All JobsDirector Aetna Case Management Jobs

Director Aetna Case Management information

See salary details

$45K

$123.6K

$199.5K

How much do director aetna case management jobs pay per year?

As of May 28, 2026, the average yearly pay for director aetna case management in the United States is $123,611.00, according to ZipRecruiter salary data. Most workers in this role earn between $98,000.00 and $141,500.00 per year, depending on experience, location, and employer.

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.

More about Director Aetna Case Management jobs
What cities are hiring for Director Aetna Case Management jobs? Cities with the most Director Aetna Case Management job openings:
What are the most commonly searched types of Aetna Case Management jobs? The most popular types of Aetna Case Management jobs are:
What states have the most Director Aetna Case Management jobs? States with the most job openings for Director Aetna Case Management jobs include:
What job categories do people searching Director Aetna Case Management jobs look for? The top searched job categories for Director Aetna Case Management jobs are:
Director Aetna Case Management jobs near you
Director of Case Management

Director of Case Management

Saint Francis Hospital

Memphis, TN • On-site

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

This job post has expired today. Applications are no longer accepted.

Job description

The individual in this position has overall responsibility for hospital utilization management, transition management, and operational management of the Case Management Department in order to promote effective utilization of hospital resources, timely and accurate revenue cycle processes, denial prevention, safe and timely patient throughput, and compliance with all state and federal regulations related to case management services. This position integrates national standards for case management scope of services including: Utilization Management supporting medical necessity and denial prevention; Transition Management promoting appropriate length of stay, readmission prevention and patient satisfaction; Care Coordination by demonstrating throughput efficiency while assuring care is the right sequence and at appropriate level of care; Compliance with state and federal regulatory requirements, TJC accreditation standards, and Tenet policy; and Education provided to physicians, patients, families, and caregivers.
  • Manage department operations to assure effective throughput and reimbursement for services provided
  • Lead the implementation and oversight of the hospital Utilization Management Plan using data to drive hospital utilization performance improvement
  • Ensure medical necessity and revenue cycle processes are completed accurately and in compliance with CMS regulations and Tenet policy
  • Ensure timely and effective patient transition and planning to support efficient patient throughput
  • develop and provide physician education and feedback on hospital utilization
  • other duties as assigned.
  • Required:
    • Education: Bachelor's degree in Business, Nursing or Health Care Administration for RN or Master's in Social Work for MSW
    • Experience: 3 years of acute hospital case management or healthcare leadership experience

  • Licensure/Certification:
    • Registered Nurse or LCSW/LMSW license.
    • Must be currently licensed, certified or registered to practice profession as required by law or regulation in state of practice or policy.
    • Active RN or LCSW/LMSW license for state(s) covered.
  • Preferred:
    • Experience: 5 years of acute hospital case management leadership multi-site experience
    • Education: MSN, MBA, MSW, or MHA
    • Licensure/Certification: Accredited Case Manager (ACM)

Are you a results-driven leader ready to make a meaningful impact to patients, caregivers, and your community? At Saint Francis Hospital hospital, were seeking an innovative and experienced healthcare leader to drive excellence and inspire our team towards exceptional patient outcomes and operational success.
At Saint Francis Hospital, we understand that our greatest asset is our dedicated team of professionals. That's why we offer more than a job - we provide a comprehensive benefit package that prioritizes your health, professional development, and work-life balance. The available plans and programs include:
  • Medical, dental, vision, and life insurance
  • 401(k) retirement savings plan with employer match
  • Generous paid time off
  • Career development and continuing education opportunities
  • Health savings accounts, healthcare & dependent flexible spending accounts
  • Employee Assistance program, Employee discount program
  • Voluntary benefits include pet insurance, legal insurance, accident and critical illness insurance, long term care, elder & childcare, auto & home insurance

Note: Eligibility for benefits may vary by location and is determined by employment status
Saint Francis Hospital-Memphis is a 479-bed full-service hospital located at 5959 Park Avenue in Memphis, TN.Offering a wide array of medical services, Saint Francis is noted for its many Centers of Excellence, including its Center for Surgical Weight Loss, Joint & Spine Center, Heart & Vascular Center, Chest Pain Emergency Center, and Surgical Services including its Center for Robotic Surgery, Diabetes Center, and Cancer Center.The hospital has been recognized for excellence of care by United Healthcare, CIGNA, Blue Cross/Blue Shield, and Aetna. Saint Francis Hospital serves as an academic training site for University of Tennessee Surgical, Family Practice, and Psychiatric Residents. The hospital is accredited by the Joint Commission on the Accreditation of Healthcare Organizations, the nations oldest and largest hospital accreditation agency. At Saint Francis Healthcare, you can grow your career skills and be a vital member of our team where we strive to be No. 1 in quality, safety and service excellence. Join our team!

Apply