Care Planner

Care Planner

 

JOB RESPONSIBILITIES:
-Provide comprehensive behavioral health care management to facilitate delivery of appropriate quality care, promote cost effective outcomes and improve program/operational efficiency involving clinical issues.

-Provide support and service to behavioral health clinical teams in support of member engagement and care
-Provides outreach to members to educate them about available specialty programs and to solicit their participation.
-Administers structured pre-screening questionnaire in order to provide relevant member information to care manager so that clinical assessment process can be facilitated by care manager.
-Educates members about available web-based resources.
-Under direction of clinical management staff and supported by care associates, conducts case management related research and coordinates both internal and external resources, assisting members with claim and benefit issue resolution, referrals to EAP, referrals to legal and financial services and referrals to community support services.
-Adheres to compliance and Patient Management policies and regulatory requirements.
-Maintains accurate and complete documentation of required information meeting risk management, regulatory and accreditation requirements.
-Participates in designated clinical quality management initiatives.
-Exhibits behaviors outlined in Employee Competencies.

SKILL OR EXPERIENCE REQUIREMENTS:
-Background/Experience Desired:
-Minimum of 2 years behavioral health care experience.
-Education and Certification Requirements:
-Associates Degree, Bachelors Degree in Psychology or Social Services preferred or equivalent work experience.

 

HOW TO APPLY:

To learn more about our employment opportunities, visit us at www.aetna.com and enter Requisition #13340 on the job search page.

 

We conduct pre-employment drug and background testing.

No agencies, please.

Aetna is an equal opportunity/affirmative action employer.