Job description

Location: Travel within Martinsville County, VA

Duration: 12 Month Contract

Shift Timing: Mon-Fri 8am-5pm

Job Description:

Develop, implement, support, and promote Health Services strategies, tactics, policies, and programs that drive the delivery of quality healthcare to establish competitive business advantage for Aetna. Health Services strategies, policies, and programs are comprised of utilization management, quality management, network management and clinical coverage and policies.

Utilizes critical thinking and judgment to collaborate and inform the case management process, in order to facilitate appropriate healthcare outcomes for members by providing care coordination, support and education for members

Responsibilities:

· Coordinates and implements assigned care plan activities and monitors care plan progress.

· Identifies and escalates quality of care issues through established channels.

· Utilizes negotiation skills to secure appropriate options and services necessary to meet the member’s benefits and/or healthcare needs

· Utilizes influencing/ motivational interviewing skills to ensure maximum member engagement and promote lifestyle/behavior changes to achieve optimum level of health

· Provides coaching, information and support to empower the member to make ongoing independent medical and/or healthy lifestyle choices

Experience:

· Minimum 1 year of relevant experience preferred · Case management and discharge planning experience preferred 2 years experience in behavioral health, social services or appropriate related field equivalent to program focus Managed Care experience preferred

Education:

· Bachelor's degree or non-licensed master level clinician required, with either degree being in behavioral health or human services preferred (psychology, social work, marriage and family therapy, counseling).

About US Tech Solutions:

US Tech Solutions is a global staff augmentation firm providing a wide range of talent on-demand and total workforce solutions. To know more about US Tech Solutions, please visit www.ustechsolutions.com.

Job Type: Full-time

Work Location: One location

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