Director of Case Management

POSITION SUMMARY

Aetna Better Health of Ohio Premier Plan is recruiting for a leader to direct the implementation and oversight of the care management program to support Ohios Medicare - Medicaid Integrated Care Delivery System (ICDS). This position is responsible for the care management strategies and daily operations of three locations, including staffing, training, reporting and community partnerships to promote quality of care for our members.

The qualified candidate shall be an Ohio-licensed registered nurse preferably with a designation as a Certified Case Manager (CCM) or equivalent credentials and experience. 3-5 years leadership experience in Medicaid and/or Medicare managed care is preferred. The candidate will be proficient in the evaluation and performance of case management operations, supporting an integrated model that includes physical and behavioral health care. Knowledge of health care regulations and the ability to work in a highly regulated environment is essential.



EDUCATION

The highest level of education desired for candidates in this position is a Master's degree.



LICENSES AND CERTIFICATIONS

Nursing/Registered Nurse is required



FUNCTIONAL EXPERIENCES

Functional - Medical Management/Medical Management - Case Management/4-6 Years

Functional - Medical Management/Medical Management - Administration/Management/4-6 Years



ADDITIONAL JOB INFORMATION

- Technical proficiency in the use of Microsoft Office Suites, including Word, Excel
- Experience managing care management programs
- Develop, build and maintain positive relationships and presence with community resources, providers and regulatory agencies
- Medicaid and Medicare experience preferred
- Managed care experience preferred







Please note that benefit eligibility may vary by position. Clickhereto review the benefits associated with this position.



Aetna does not permit the use of tobacco related products or drugs in the workplace.