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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