Aetna Care Coordinator

Aetna Care Coordinator – MHN

Friend Health is seeking an Aetna Care Coordinator to support patient care within the Aetna Better Health IL - Managed Healthcare Network (MHN) program. This role serves as a liaison between patients, families, and clinical teams to ensure coordinated, patient-centered care. The Aetna Care Coordinator will assist with patient assessments, referrals, care coordination, and follow-up services to improve health outcomes, reduce gaps in care, and enhance patient engagement.

Essential Job Duties & Responsibilities

Patient Coordination & Support

• Perform Health Risk Assessments to evaluate patient needs.
• Assist with care coordination, ensuring smooth communication between the clinical team, patient, and families.
• Provide disease-specific and preventive care education to patients.
• Assist with referrals, transitions of care, and scheduling appointments as needed.
• Ensure timely follow-ups with providers after hospitalizations and emergency room visits.
• Coordinate services in alignment with Aetna Better Health IL - MHN program guidelines.

Data Management & Reporting

• Retrieve discharge summaries and medical records to support patient care.
• Utilize Electronic Health Records (EHR) and Practice Management Systems accurately and efficiently.
• Compile reports, enter, track, and monitor patient data for compliance with MHN program metrics.

Community Engagement & Outreach

• Participate in care management team meetings to discuss patient needs and care strategies.
• Conduct home visits if necessary to ensure patients follow their care plans.
• Serve as a resource for patients in need of social services, transportation, or housing support.

Customer Service & Compliance

• Provide exceptional customer service by demonstrating courtesy, tact, and professionalism.
• Maintain confidentiality and discretion in all interactions, adhering to HIPAA regulations.
• Respond to all incoming and outgoing calls professionally and record patient information accurately.
• Ensure compliance with Aetna Better Health IL - MHN policies and reporting requirements.
• Perform other duties as required or assigned within the scope of the role.

Educational Requirements

• High school diploma or equivalent required.

Experience & Training

• 2-3 years of direct public contact experience, emphasizing customer service, oral/written communication, and telephone etiquette.
• Experience with Electronic Health Records (EHR) required.
• Strong key entry and/or typing skills.
• Familiarity with managed care organizations (MCOs), care management, or working with Medicaid populations is a plus.

Compensation & Benefits

Friend Health offers a competitive salary based on experience and qualifications, along with a comprehensive benefits package, including:

• Medical, Dental, and Vision Insurance
• 403(b) Retirement Plan with Employer Contributions
• Paid Time Off (PTO) & Paid Holidays
• Life Insurance & Disability Coverage
• Tuition Reimbursement & Professional Development Opportunities
• Wellness Programs & Employee Assistance Programs (EAP)

Salary Range: $21.00-$22.55

Occupational Risk & Compliance

This position involves extensive patient contact, increasing the risk of exposure to tuberculosis (TB). Employees are required to comply with annual TB testing and flu vaccination policies. Exceptions are granted only for documented medical contraindications or religious objections, and employees who decline vaccinations will be required to wear a mask as appropriate.

Equal Employment Opportunity (EEO) Statement

Friend Health – HRDI is an equal opportunity employer. We consider all applicants for employment without regard to race, religion, color, age, sex, national origin, citizenship, ancestry, marital or parental status, sexual orientation (including gender identity and expression), military discharge status, physical or mental disability, or any other protected status under applicable laws.

Additionally, Friend Health – HRDI provides reasonable accommodations to qualified individuals with disabilities in accordance with the Americans with Disabilities Act (ADA) and applicable state/local laws, including during the hiring process.

Join Our Team!

If you are a dedicated and compassionate professional passionate about coordinating patient care within a managed healthcare setting, we encourage you to apply! Join Friend Health today and help make a lasting impact on community healthcare.