Registered Nurse (RN) â" Remote Utilization Management Nurse Consultant
Location: Middletown Connecticut
Description: Aetna is in need of Registered Nurse (RN) â" Remote Utilization Management Nurse Consultant right now, this vacancy will be placed in Connecticut. Further informations about this vacancy opportunity please give attention to these descriptions. Req ID: 14417BR
This position offers work at home potential. External candidates m! ust be within a commuting distance to the Hartford, CT office. Current internal candidates working from home can be located anywhere in the country, but must work a schedule within EST.POSITION SUMMARY
Utilizes clinical skills to coordinate, document and communicate all aspects of the utilization/benefit management program. This position is for a telephonic Utilization Management Nurse Consultant for management of Aetna's Student Health membership. This RN will partner with the hospital UR staff to plan and facilitate a timely and safe transfer of the member to the next appropriate level of care. More specifically, the inpatient care process includes: obtaining necessary information from providers and facilities concerning the care being provided to members; the assessment of a member's clinical condition and ongoing medical services and treatments to determine medical appropriateness; guide the setting for medical intervention to achieve optimum length of stay for memb! ers; the early identification of continuing care needs to faci! litate discharge to the appropriate setting and discharge planning & coordination. This RN works collaboratively with the Aetna Medical Director, case managers, hospital staff and attending physicians.
The ideal candidate is a Registered Nurse (RN) with an unrestricted license and minimum 3-5 years clinical experience. The candidate has the ability to exercise independent and sound judgment, has strong decision-making skills and well-developed interpersonal skills. Ability to manage multiple priorities, effective organizational and time management skills along with strong teamwork skills. Managed Care experience and prior experience within a telephonic customer service center type of environment is preferred. Candidate must possess good computer skills.
EDUCATION
The highest level of education desired for candidates in this position is a Bachelor's degree or equivalent experience.
LICENSES AND CERTIFICATIONSNursing/Registered Nurse (RN) is req! uired.FUNCTIONAL EXPERIENCES
Functional - Nursing/Concurrent Review/Discharge Planning/1-3 Years
Functional - Nursing/Medical-Surgical Care/1-3 Years
Functional -Clinical/Medical/Direct Patient Care (Hospital, Private Practice)/4-6 YearsFunctional - Nursing/Home Health Care Ambulatory Nursing/1-3 Years
TECHNOLOGY EXPERIENCES
Technical - Desktop Tools/Microsoft Outlook/1-3 Years
Technical - Desktop Tools/Microsoft Explorer/1-3 Years
Technical - Desktop Tools/Microsoft Word/1-3 Years
REQUIRED SKILLS
Benefits Management/Interacting with Medical Professionals
Benefits Management/Maximizing Healthcare Quality
General Business/Applying Reasoned Judgment
DESIRED SKILLS
Service/Providing Solutions to Constituent Needs
Leadership/Driving a Culture of Compliance
General Business/Turning Data into Information
Please note that benefit eligibility may vary by position. Clickhereto review the benefits associat! ed with this position.
Aetna does not permit the use of tobacc! o related products or drugs in the workplace.
Job Function: Health Care
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If you were eligible to this vacancy, please email us your resume, with salary requirements and a resume to Aetna.
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This vacancy starts available on: Thu, 14 Nov 2013 17:23:00 GMT
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