• Assessing, planning, implementing, and coordinating all case management activities with members to evaluate the medical needs of the member to facilitate the member’s overall wellness • Developing a proactive course of action to address issues presented to enhance the short and long-term outcomes as well as opportunities to enhance a member’s overall wellness through integration • Conducting an evaluation of member’s needs and benefit plan eligibility and facilitating integrative functions as well as smooth transition to Aetna programs and plans • Applying clinical judgment to the incorporation of strategies designed to reduce risk factors and barriers and address complex health and social indicators which impact care planning and resolution of member issues • Reviewing prior claims to address potential impact on current case management and eligibility • Assessing the member’s level of work capacity and related restrictions/limitations • Consulting with supervisor and others in overcoming barriers in meeting goals and objectives, presents cases at case conferences for multidisciplinary focus to benefit overall claim management