Manager Aetna Case Management Jobs in Rutland, VT

Coordinates and implements the vocational training or retraining necessary to return the claimant to the workplace. Conducts transferable skills analysis, vocational testing/evaluation, job analysis, and job search activities. Coordinates claimant participation in various programs, activities and services designed to prepare them for re-entry to the workforce.

Responsibilities:

Coordinate the individual's vocational training program while maximizing cost containment by getting the injured worker back to work. Performance is monitored by supervisors and is evaluated in relation to the overall branch performance/revenues.

Conduct vocational assessment interviews and tests, which, in conjunction with the medical information and release, will allow the formulation of vocational goals. Must practice proper testing techniques and interpret the results without error to avoid complicating the claimant's rehabilitation and to return them to work.

Works with the physicians and therapists to set up medical assessments to identify physical and mental capabilities which will aid in counseling the injured worker on vocational alternatives should limitations call for another type of work, or if necessary and appropriate, retraining.

Researches training and pain programs, coordinates participation and monitors the individual's success over the course of the program.

Works with employers (past or potential) and employment placement facilities on modifications to job duties based on medical limitations and the employee's functional assessment. Conducts job analysis to ensure a match before placing the client in the job; obtains, when necessary, physician approval.

Provides job search skills training to claimants. Instructs on completing applications, identifying job markets, improving interview skills. Counsels them on alleviating anxiety and dealing with potentially negative attitudes among employers and employees.

Coordinates the injured worker's appointments and arranges and/or may personally escort them to the appointments.

After placement, follows up by visiting the worksite, and evaluating activities and assessing performance.

May provide exert testimony on litigated cases.

Develops knowledge of current job market to identify alternative placements.

Maintains all case documents in files ensuring a comprehensive and detailed source of information for all parties involved in the case.

Prepares detailed evaluation reports, as per account guidelines, and case notes documenting each phase of activity as it is completed. Reports billing hours in accordance with case activity and billing practices.

Maintains phone contact with all parties involved to monitor, update, and advance the vocational rehabilitation and to ensure that the case progresses.

Compiles a case inventory monthly for submission to the branch manager to allow for proper billing and to calculate hours for bonus purposes.

Completes insurance carrier reports on a monthly (or as required) basis, as well as other necessary paperwork for the insurance company, state, or other regulatory bodies.

Coordinates case management with attorneys, insurance carriers, physicians, employers, and claimants. Serves as a main liaison in the rehabilitation process.

Maintaining the necessary credentials and demonstrating a level of professionalism within the work place and in dealing with injured workers reflects positively on the company. Professionalism is monitored daily by management.

May assist in training/orientation of new staff as requested.

Monitors functions assigned to non-case managers and provides input on the performance of support staff to their supervisor.

Other duties may be assigned.

Qualifications:

EDUCATION:B.S., B.A., in vocational evaluation, special education, behavioral psychology, or related field required. Masters level and/or advanced study strongly preferred or as required by state law.

EXPERIENCE:Prior industry-related experience preferred.

MINIMUM QUALIFICATIONS:Meets all vocational case management eligibility requirements of the state/jurisdiction of hire.

CERTIFICATES, LICENSES, REGISTRATIONS:C.R.C., C.C.M., C.D.M.S., L.R.C. or C.V.E. eligibility required. Actual certification preferred, or as required by state law. Valid driver's license required.

OTHER QUALIFICATIONS:Prior vocational case management experience preferred. Background in state workers' compensation law and practices desirable. Excellent interpersonal skills and phone manners. Excellent organizational skills. Ability to set priorities. Ability to work independently. Computer literacy required.