…Informs social worker/case manager of the patients' available benefits through insurance/ managed care provider. Assists in providing community resources/services

…+ LTSS experience + Case management and/or discharge planning experience + Managed Care experience + Medicaid and Medicare experience + Experience

…+ Three to five (3-5) years in MLTC, LTHHCP, MAP, PACE, or other managed care programs. + Experience working independently without significant oversight or

…for the duration of their employment. PREFERRED QUALIFICATIONS Previous knowledge of managed care concepts. Working knowledge of medical terminology and ICD-9

…executing Population Health Management strategies across a health system and/or health plan/ managed care organization, highly desired + Successful achievement of

…this opportunity with Aetna, a CVS Health company! Aetna operates Medicaid managed care plans in multiple states: Arizona, California, Florida, Illinois,

…all matters related to clinical operations, including (but not limited to) managed care , patient billing, confidentiality protocols, and disseminates information

…experience and requires a minimum of 2 years clinical, utilization review, or managed care experience; or any combination of education and experience, which

…of Discharge Planning/ Utilization Management / Case Management terminology and functions, in both managed care and non- managed care environments. 2.

…commitment to providing high-quality pharmaceutical care in a hospital or managed care setting. Responsibilities + Review and interpret medication orders to