Aetna Inc.

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Manager of Clinical Case Management

at Aetna Inc.

Posted: 5/21/2019
Job Reference #: 63742
Keywords: healthcare, health

Job Description

Job Description

The Manager of Clinical Case Management will develop, implement, support, and promote case management strategies, tactics, policies, and programs that drive the delivery of quality healthcare to establish competitive business advantage for Aetna.


Job Group
Health Care

Full or Part Time
Full Time

Supervisory Responsibilities

Percent of Travel Required
10 - 25%

Posting Job Title
Manager of Clinical Case Management

Potential Telework Position

Additional Locations

Primary Location (City, State)

EEO Statement
Aetna is an Equal Opportunity, Affirmative Action Employer

Resource Group

Additional Job Information

Candidates must be local to Philadelphia, PA  this is an onsite position.
Experience with Pennsylvania Medicaid is strongly preferred. 

License in Pennsylvania required.

Travel approximately 15 %

Fundamental Components

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.

initiate, monitor and communicate performance expectations. 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.

Background Experience
  • 5+ years of Clinical (Case Management) experience; Required

  • Active unrestricted State Licensure in applicable functional area; Required (eg RN, LPC, LSW, LCSW)

  • Master's degree in behavioral health field; or Registered Nurse (BSN preferred) ; Required

  • Experience with Pennsylvania Medicaid; Strongly Preferred. 

  • Leadership Experience; Strongly Preferred

Required Skills
Benefits Management - Maximizing Healthcare Quality, Benefits Management - Understanding Clinical Impacts, General Business - Communicating for Impact, Leadership - Collaborating for Results, Leadership - Driving a Culture of Compliance, Leadership - Engaging and Developing People

Minimum Education Level
Mental Health - Licensed Clinical Social Worker, Mental Health - Licensed Professional Counselor, Nursing - Registered Nurse (RN)

Benefits Program
Benefit eligibility may vary by position. Click here to review the benefits associated with this position.

Candidate Privacy Information
Aetna takes our candidate's data privacy seriously. At no time will any Aetna recruiter or employee request any financial or personal information (Social Security Number, Credit card information for direct deposit, etc.) from you via e-mail. Any requests for information will be discussed prior and will be conducted through a secure website provided by the recruiter. Should you be asked for such information, please notify us immediately.