Remote Aetna Case Management Jobs in Reston, VA (NOW HIRING)

Overview

Are you looking to make a difference by providing high-quality care with a personal touch that impacts the lives of workers? Would you like to be part of a team focused on empowering and sustaining health by supporting the occupationally injured? Do you have the professional nursing, case management experience, and licenses necessary to help further establish MCA as a leading case management company? Do you have experience with workers' compensation?

We believe in helping those with work-sustained illnesses and injuries to live their best life by providing care, health management, and support through our highly skilled team of home-based Medical Case Managers (MCM).

Responsibilities

As a Medical Case Manager, you will work independently in your home office setting while still being part of a supportive nationwide team. Through the application of a unique mix of experience and certification, you will support federal workers with diagnoses in the fields of occupational-related injuries and illness, emphasize timely facilitation and coordination of diagnosis, and be involved in the acute and chronic phases of treatment and support. Your broad responsibilities will include developing a case management plan for each injured worker throughout the various stages of recovery while tracking in a database patient improvement goals. You will implement integrated medical disability case management services to prevent, minimize, or overcome a disability, as well as provide medical expertise and serve as the critical communication link between the parties involved in any medical disability case.

Qualifications

• High School Diploma or equivalent (GED) required
• Bachelor of Science in Nursing (BSN) or related field preferred
• Current, active, unrestricted resident RN license within the United States required; Compact License preferred
• 3+ years related clinical experience with at least 1 year in workers' compensation, utilization review, disability case management, occupational health, and/or comparable field
• National certification in case management or a related field preferred
• Reliable high-speed cable or fiber optic internet service and an established home office environment
• Strong attention to detail with excellent organizational and time management skills
• Proficiency with Microsoft Office applications, including Word, Excel, and Outlook
• Experience using case management systems, electronic medical records (EMR) or other electronic platforms
• Ability to utilize telehealth technologies, including video and chat platforms, when appropriate.
• Ability to work independently while collaborating effectively within a team environment
• Excellent communication and documentation skills with the ability to provide timely follow-up, including 24-hour follow-up on communications and effective coordination among all parties involved in the case
• Must successfully pass a preliminary credit and background check prior to hire
• Upon hire, a federal security clearance will be required

For a career path that is both challenging and rewarding, join Sedgwick Government Solutions talented team. Taking care of people is at the heart of everything we do. Our clients depend on our talented colleagues to take care of their most valuable assetstheir employees, and their customers. At Sedgwick Government Solutions, caring counts®. Join our team of creative and caring people of all backgrounds and help us make a difference in the lives of others.

Sedgwick Government Solutions provides a reasonable range of compensation for roles that may be hired in jurisdictions requiring pay transparency in job postings. Actual compensation is influenced by a wide range of factors including but not limited to skill set, level of experience, and cost of a specific location. For the jurisdiction noted in this job posting only, the range of starting pay for this role is ($78,000-$82,000). A comprehensive benefits package is offered including, but not limited to, medical, dental, vision, 401k and matching, PTO, disability and life insurance, employee assistance, flexible spending or health savings account, and other additional voluntary benefits.

To be considered for this position, please submit a resume, and complete the application.

The information provided above has been designed to indicate the general nature and level of work of the position. It is not a comprehensive inventory of all duties, responsibilities, and qualifications required.

Important Information

Successful candidates will be required to undergo a financial and criminal background check and obtain and maintain confidential-level security clearance upon hire. We participate in the United States Federal Government E-Verify program to confirm the employment authorization of the employee upon hire.

Search Firm Representatives

Please be advised that Sedgwick Government Solutions is not seeking assistance or accepting unsolicited resumes from search firms for this employment opportunity. Regardless of past practice, a valid written agreement and task order must be in place before any resumes are submitted to Government Solutions. All resumes submitted by search firms to any employee at Government Solutions without a valid written agreement and task order in place will be deemed the sole property of Government Solutions and no fee will be paid in the event that person is hired by Government Solutions.

Government Solutions strives to make our career site accessible to all users. If you need a disability-related accommodation for completing the application process, please contact Government Solutions regarding accommodations.

Sedgwick Government Solutions is an Equal Opportunity and Affirmative Action Employer

All qualified applicants will receive consideration for employment without regard to age, citizenship status, color, disability, marital status, national origin, race, religion, sex, sexual orientation, gender identity, veteran status, or any other classification protected by federal state or local laws as appropriate, or upon the protected status of the persons relatives, friends or associates.

Sedgwick Government Solutions abides by the requirements of 41 CFR 60-741.5(a). This regulation prohibits discrimination against qualified individuals on the basis of disability and requires affirmative action by covered prime contractors and subcontractors to employ and advance in employment qualified individuals with disabilities.

Sedgwick Government Solutions abides by the requirements of 41 CFR 60-300.5(a). This regulation prohibits discrimination against qualified protected veterans and requires affirmative action by covered prime contractors and subcontractors to employ and advance in employment qualified protected veterans.

About Sedgwick Government Solutions

Sedgwick Government Solutions is a trusted partner for federal agencies across the U.S., helping them confidently manage risk and claims. With decades of experience and deep regulatory expertise, we keep agencies compliant while improving their workforces health and productivity. Backed by the most advanced technology, our tailored solutions help agencies navigate the complexities of federal risk and claims management. Sedgwick Government Solutions

Compensation details: 78000-82000 Yearly Salary

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