Aetna Customer Service – Work From Home $26 Hour

Job Description

Aetna Customer Service – Work From Home $26 Hour

Job Responsibilities: Clinical Team Lead

Hiring Organization: Aetna

Educational Requirements: Post Graduation

Industry: Private

Employment Type: Full Time

Salary: $26-$36/Hour

Location: Topeka, USA

Full Job Description:-

Position Summary

Administers processes to coordinate and facilitate comprehensive care for individuals by assessing their needs, developing personalized care plans, and coordinating services across healthcare providers. Serves as an advocate for patients, ensuring effective communication, resource utilization, and continuous monitoring of their progress to promote positive outcomes and enhance overall well-being. The Clinical Team Lead is accountable to leadership to support the day-to-day operations of the team. This position has no supervisory oversight of staff. However, does require a solid understanding of the workflows, policies, and procedures to ensure the team is functioning at a successful level, as evidenced by meeting performance guarantees and plan sponsor expectations. The role requires promoting cooperation and team-building between all department members. Aetna Customer Service – Work From Home $26 Hour

Fundamental Components/Expectations

• Serve as a content model expert for the regional team
• Mentor team regarding best practice standards, quality of interventions, problem resolution, and critical thinking
• Provide support to the CM staff in real-time. Aetna Customer Service – Work From Home $26 Hour
• Provide support ongoing to ensure adherence to plan sponsor performance targets
• Must be able to articulate the requirements to meet each performance goal
• Provides ongoing education to staff regarding opportunities and processes
• Will review and have a solid understanding of Policies and Procedures and support these
• Will provide support and education related to critical thinking and problem-solving
• Escalated Case resolution and team education post-resolution
• Communicate effectively with a variety of audiences. Aetna Customer Service – Work From Home $26 Hour
• Conducts routine data cleaning to ensure that the electronic health records (EHR) system contains data that is accurate and reliable
• Collaborate effectively with various levels of peers, leaders, and cross-functional partners to maintain quality metrics and understand/influence opportunities for process improvement.
• Organized and able to prioritize tasks: Aetna Customer Service – Work From Home $26 Hour
• Assists Supervisors with reports as assigned to understand trends and how best to maintain a high level of service
• Designs complex collaboration tools to facilitate effective clinical teamwork and information sharing on clinical outcomes.
• Identifies opportunities to help clinical case managers schedule appointments, coordinate referrals, and share important documents securely. Aetna Customer Service – Work From Home $26 Hour
• installs reporting tools and dashboards to help identify trends, measure the impact of interventions, and inform decision-making for quality improvement initiatives.
• Maintain adjusted caseload
• May assist with project logistics including agenda, meeting arrangements, and minutes
• Collect and write up success stories as needed
• Precept Staff as needed
• Serve as a Subject Matter Expert regarding daily workflows
• Support a positive work environment that promotes the concept of teamwork
• The team Lead will consult frequently with the Regional Supervisor/Manager and keep the line of communication open
• Team Leads may assume the task list duties for CM PTO and work those cases accordingly

Required Qualifications

• Active unrestricted KS State Licensure in the applicable functional area- RN or Clinical BH license (Ex – LCPC, LCSW, LMFT, or LMHC). Aetna Customer Service – Work From Home $26 Hour
• 3+ years of clinical experience required.
• Willing and able to travel up to 25% of their time to meet members face to face within the western region of KS ( Northwest, west-central, and Southwest). Aetna Customer Service – Work From Home $26 Hour
• Reliable transportation is required; Mileage is reimbursed per our company expense reimbursement policy.

Preferred Qualifications

• 3+ years of managed care experience.
• Requires proficiency with computer skills which includes navigating multiple systems and keyboarding
• Excel experience preferred
• Time-efficient and highly organized
• Exceptional communication skills
• Ability to mentor and support staff to meet business needs
•   Working knowledge of problem-solving and decision-making skills.
•  Working knowledge of medical terminology.
• Working knowledge of digital literacy skills. Aetna Customer Service – Work From Home $26 Hour
• Ability to deal tactfully with customers and community.
• Ability to handle sensitive information ethically and responsibly. Aetna Customer Service – Work From Home $26 Hour
• Ability to consider the relative costs and benefits of potential actions to choose the most appropriate option.
• Ability to function in clinical settings with diverse cultural dynamics of clinical staff and patients.

-: USA Job Market Trends:-

Right here are a few standard traits that have been affecting the process marketplace within side the United States. Please note that the process marketplace is a challenge to change, and for the maximum modern-day and correct information, it is critical to consult the modern-day reviews and records from

1. Remote Work and Hybrid Models: The COVID-19 pandemic caused a sizable growth in remote work and bendy work arrangements. Many employers and personnel embraced remote and hybrid work models, which can affect how jobs are established within side the future
2. Technology and Digital Skills: The call for technology-associated skills, which include coding, records analysis, and virtual marketing, has been continuously high. Technology-pushed roles have been at the upward thrust throughout numerous industries.
3. Healthcare and Biotechnology: The pandemic highlighted the significance of the healthcare sector, mainly due to the persistent boom in roles associated with healthcare, pharmaceuticals, biotechnology, and clinical research.
4. Renewable Energy and Sustainability: There has been growing interest in renewable power reasserts and sustainability practices, using process boom in regions like smooth power, environmental conservation, and inexperienced technology.
5. E-Commerce and Logistics: The shift toward online purchasing has pushed a call for jobs in e-trade platforms, delivery chain management and last-mile logistics
6. Cybersecurity: With the growing reliance on virtual infrastructure, cybersecurity has ended up a crucial concern, main to a developing call for expert professionals in cybersecurity and records protection.
7. Health and Well-being: Companies have been focusing extra on worker well-being, mainly to accelerate the call for roles associated with intellectual fitness support, well-being programs, and work-life stability initiatives.
8. Skilled Trades and Vocational Roles: Skilled trades which include electricians, plumbers, and mechanics have visible a scarcity of workers, supplying possibilities for people inquisitive about vocational careers.
9. Diversity, Equity, and Inclusion (DEI): Organizations are setting extra emphasis on developing various and inclusive work environments, mainly due to the emergence of roles targeted at DEI initiatives.
10. Gig Economy and Freelancing: The gig financial system continues to grow, providing possibilities for people to work as freelancers, consultants, and impartial contractors in numerous industries.
11. Aging Workforce and Succession Planning: The growing old populace has triggered discussions approximately the body of workers making plans and skills succession techniques in industries with a big percentage of older workers Reskilling and Upskilling: Lifelong mastering and non-stop talent improvement have ended up critical as industries evolve rapidly. Many people are looking for possibilities to reskill or upskill to stay aggressive within side the process marketplace.

Aetna Customer Service – Work From Home $26 Hour