Case Management Coordinator
This is telework position with up to 80% travel in The Lakes Region. Candidate may reside in or adjacent to the following counties: Fulton, Hickman, Carlisle, Ballard, Graves, McCracken, Calloway, Marshall, Livingston, Crittenden, Caldwell, Hopkins, Christian, Muhlenberg, Todd counties of KY.
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.
Oversight and Management of clinical team processes including the organization and development of high performing teams.
Care coordination with community partners to ensure successful reduction of risk of placement in an acute psychiatric facility, long term residential facility or disruption of placement.
• Reinforces clinical philosophy, programs, policies and procedures.
• Communicates strategic plan and specific tactics to meet plan.
• Ensures implementation of tactics to meet strategic direction for cost and quality outcomes.
• Creates direction and communicates a business case for change by focusing on and addressing key priorities to achieve business results.
• Identifies opportunities to implement best practice approaches and introduce innovations to better improve outcomes.
• Accountable for meeting the financial, operational and quality objectives of the unit.
• May be accountable for the day-to-day management of teams for appropriate implementation and adherence with established practices, policies and procedures if there is not supervisor position
• Works closely with functional area managers to ensure consistency in clinical interventions supporting our plan sponsors.
• Develop, initiate, monitor and communicate performance expectations.
• May act as a single point of contact for the customer and the Account Team which includes participation in customer meetings, implementation and oversight of customer cultural requirements, and support implementation of new customers.
• Participate in the recruitment and hiring process for staff using clearly defined requirements in terms of education, experience, technical and performance skills.
• Assesses developmental needs and collaborates with others to identify and implement action plans that support the development of high performing teams.
• Consistently demonstrates the ability to serve as a model change agent and lead change efforts.
• Accountable for maintaining compliance with policies and procedures and implements them at the employee level.
• Ability to evaluate and interpret data, identify areas of improvement, and focuses on interventions to improve outcomes.
The typical pay range for this role is:
Please keep in mind that this range represents the pay range for all positions in the job grade within which this position falls. The actual salary offer will take into account a wide range of factors, including location.
• 2 years’ experience in behavioral health, social services, or human services field.
• 1 year experience with MS Office Suite applications, including Word and Excel.
-Willing and able to travel 80-90% to meet members face to face in the Lakes Region.
• Flexibility to work beyond core business hours of Monday-Friday, 8am-5pm, is required, as we are serving the needs of children and families that may require working after school, after work, etc.
• Knowledge of growth and developmental milestones.
• Care management experience
• Discharge planning experience
• Managed Care experience
• 6 months of Experience and detailed knowledge of the Foster Care and juvenile justice systems, Adoption Assistance, the delivery of Behavior Health Services, Trauma-informed Care, ACEs, Crisis Intervention services, or evidence-based practices applicable to the Kentucky SKY populations.
Minimum of a Bachelor's degree or a non-licensed master level clinician is required with either degree being in behavioral health or a relevant human services field of study (social work, psychology, marriage and family therapy, counseling) required.
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