Job Description
Aetna Job Submission Status $24/Hour
Job Responsibilities: Care Management Associate
Hiring Organization: Aetna
Educational Requirements: Bachelor Degree
Industry: Private
Employment Type: Full Time
Salary: $24-$30/Hour
Location: Idaho, USA
DESCRIPTION:
Expected set of responsibilities
This Care The executive’s Partner position is a 100 percent remote work-from-home position. The representative can live in any state.
Ordinary Working Hours: Monday through Friday 12:30 pm9:00 pm EST.
There are intermittent Saturday moves and occasion shifts that are presently filled on a worker’s premises. If it becomes required, it will be around one Saturday for each quarter and 1 occasion each year however is per the need of the division. The hours on Saturdays are normally 8:00 a.m. to 4:30 p.m. EST.
There is no movement expected with this position.
This Care The executive Partner position is important for a high volume call focus and the worker will be replying to between 40 to 60 calls each day (the group handles nearly 10,000 calls each month by and large).
The Consideration The executive Partner is supposed to be at their workstation signed into their PC and telephone framework and noting calls over the day. The Group’s administration can screen every representative’s commitment, volume, and movement over the day.
Experience with a high volume call focus climate is a basic part of effective onboarding into the job. Aetna Job Submission Status
Kindly apply on the off chance that you have worked in a called community for a very long time. Up-and-comers without this experience won’t be consulted.
The Consideration The board Partner upholds farreaching coordination of clinical benefits including Care Group admission, screening, and supporting the execution of care intends to advance the successful use of medical care administrations. Advances/upholds quality adequacy of Medical care Administrations. Aetna Job Submission Status
The Consideration The Board Partner:
- Liable for beginning survey and emergency Care Group assignments.
- Distinguishes chief justification for confirmation, office, and part item to accurately apply mediation evaluation devices.
- Screen patients utilizing designated mediation business rules and cycles to recognize required clinical benefits, make suitable references to clinical benefits staff, and direct the necessary administrations as per the Advantage Plan.
- Screens nondesignated cases for sections of suitable release date and attitude.
- Recognizes and alludes anomaly cases (e.g., Length of Stay) to clinical staff.
- Distinguishes triggers for reference into Aetna’s Case The executives, Sickness The board, Blended Administrations, and other Specialty Projects.
- Uses Aetna frameworks to construct, research, and enter part data, depending on the situation.
- Support the Turn of Events and Execution of Care Plans.
- Facilitates and sorts out medical care administration conveyance under the course of attendant or clinical chief in the most fitting setting at the most suitable cost by distinguishing potential open doors for the patient to use partaking suppliers and administrations Advances correspondence, both inside and remotely to upgrade viability of clinical administration administrations (e.g., medical care suppliers, and medical services colleagues separately)
- Performs nonclinical examination appropriate to the foundation, support, and conclusion of open cases
- Offers help administrations to colleagues by noting calls, taking messages, exploring data, and helping with tackling issues.
- Sticks to Consistence with PM Arrangements and Administrative Guidelines.
- Keeps up with precise and complete documentation of required data that meets risk the board, administrative, and authorization necessities.
- Safeguards the privacy of part data and sticks to organization arrangements regarding secrecy.
- May aid the examination and goal of case installment issues.
- Upholds the organization of the medical clinic care, case the board and quality administration processes in consistency with different regulations and guidelines, URAQ or potentially NCQA principles, Case The executives Society of America (CMSA) norms where material, while complying to organization strategy and techniques. (*)
- Powerful correspondence, telephonic, and association abilities.
- Knowledge of essential clinical wording and ideas utilized in the care of the board.
- Solid client support abilities to facilitate administration conveyance including thoughtfulness regarding clients, aversion to issues, proactive recognizable proof, and goal of issues to advance positive results for individuals.
- PC education to explore through inward/outside PC frameworks, including Succeed and Microsoft Word.
- Capacity to partake in a multidisciplinary group including inward and outer members.
Required Capabilities
- Should have call focus insight (at least a half year experience). Kindly don’t mind on the off chance that you don’t have a half year of call focus insight as you won’t be evaluated.
- Experience with PCs including information on Microsoft Word, Viewpoint, and Succeed
- Capability in composing for entering data and exploring various frameworks
- Requires extensive stretches of sitting and phone and PC work.
Favored Capabilities
- Information passage and documentation
- Clinical phrasing information
- Solid telephonic relational abilities
- Solid hierarchical abilities with a capacity to focus on errands to fulfill time-delicate time constraints
- Compelling verbal and composed correspondence abilities with the two clients and partners
- 2 years of involvement with either client assistance, selling as well or deals
Schooling
- Secondary School confirmation or comparable experience.
Business Outline
Carry your heart to CVS Wellbeing All of us at CVS Wellbeing share a solitary, clear reason: Carrying our heart to each snapshot of your wellbeing. This reason directs our obligation to convey upgraded human-driven medical care for a quickly influencing world. Secured in our image with the heart at its middle our motivation sends an individual message that how we convey our administrations is pretty much as significant as what we convey. Our Heart At Work Behaviors supports this reason. We need every individual who works at CVS Wellbeing to feel engaged by the job they play in changing our way of life and speeding up our capacity to advance and convey answers to make medical care more private, advantageous, and reasonable. We endeavor to advance and support a culture of variety, incorporation, and having a place consistently. CVS Wellbeing is a governmental policy regarding minorities in society boss and is an equivalent open door manager, similar to the doctor-claimed organizations for which CVS Wellbeing gives the executives administrations. We don’t segregate in enlisting, employing, advancement, or some other staff activity in light of race, nationality, variety, public beginning, sex/orientation, sexual direction, orientation personality or articulation, religion, age, handicap, safeguarded veteran status, or some other trademark safeguarded by material government, state, or nearby regulation. We gladly support and empower individuals with military experience (dynamic, veterans, reservists, and Public watchmen) as well as military life partners to go after CVS Wellbeing position valuable open doors.
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Aetna Job Submission Status $24/Hour