Case Management Analyst - Must live near Aurora, Naperville, or Joliet IL
Core
Field-based Case Management Analyst for Aetna's Long-Term Services & Supports (LTSS) team, conducting in-person care coordination and evaluations for waiver members in Illinois.
Role type
Field-based Case Management Analyst
Builds
Care plans and healthcare outcomes for LTSS/waiver members
Domain
Health insurance / Long-Term Services & Supports
Required skills
Care coordination, care plan implementation, member evaluation, benefit plan analysis, crisis intervention referral, quality of care monitoring, regulatory compliance, motivational interviewing, negotiation, data review
Preferred skills
Discharge planning, managed care, HIV/AIDS population experience, multi-lingual proficiency
Technologies
Microsoft Office, electronic health records (EHR), case management tools
Responsibilities
Conduct comprehensive evaluations of member needs and eligibility; coordinate and monitor assigned care plan activities; consult with medical directors and supervisors to overcome care barriers; present cases at multidisciplinary conferences; identify high-risk factors and escalate quality issues; provide coaching and support to empower members in healthcare decision-making.
Seniority
Mid-level, hands-on IC