UM Nurse Consultant
Location: Albany, New York
Description: Aetna is currently interviewing UM Nurse Consultant right now, this vacancy will be arranged in New York. Detailed specification about this vacancy opportunity kindly see the descriptions. Position sits in our Albany, NY office. Internal candidates already WAH can remain WAH.
Role will require a Friday evening and Saturday shift on a rotational basis.
Position Summary:
Utilizes clinical skills to coordinate, document and communicate all aspects of the utilization/benefit management program. Requires an RN with unrestricted active license.
Additional Job Responsibilities:
Reviewing services to assure medical necessity
Applying clinical expertise to assure appropriate benefit utilization
Facilitate safe and efficient discharge planning
Work closely with facilities and providers to meet the complex needs of the member
Background/Experience:
Minimum of 3+ years of clinical experience required
Effective communication skills, both written and verbal
Ability to multi-task, prioritize and effectively adapt to a fast paced, deadline driven environment
Managed Care experience preferred
Concurrent review/discharge planning experience preferred
Education:
The minimum level of education required for candidates in this position is a Bachelor's degree or equivalent experience
Licenses and Certifications:
Registered Nurse (RN) with active state license in good standing required
Certified Case Manager (CCM) preferred
Functional Experiences:
Functional - Nursing/Clinical coverage and policies/1+ Years
Functional - Nursing/Concurrent Review/discharge planning/1+ Years
Technology Experiences:
Technical - Desktop Tools/Microsoft Outlook/1+ Years/End User
Required Skills:
Benefits Management/Interacting with Medical Professionals/3+ years/ADVANCED
Benefits Management/Maximizing Healthcare Quality/1+ years/FOUNDATION
Leadership/Collaborating for Results/3+ years/ADVANCED
Desired Skills:
Benefits Management/Supporting Medical Practice/3+ years/ADVANCED
Leadership/Driving a Culture of Compliance/1+ years/FOUNDATION
Service/Providing Solutions to Constituent Needs/3+ years/ADVANCED
Additional Job Information:
We value leadership, creativity and initiative. If you share those values and a commitment to excellence and innovation, consider a career with our company.
Aetna is about more than just doing a job. This is our opportunity to re-shape healthcare for America and across the globe. We are developing solutions to improve the quality and affordability of healthcare. What we do will benefit generations to come.
We care about each other, our customers and our communities. We are inspired to make a difference, and we are committed to integrity and excellence.
Together we will empower people to live healthier lives.
Aetna is an equal opportunity & affirmative action employer. All qualified applicants will receive consideration for employment regardless of personal characteristics or status. We take affirmative action to recruit, select and develop women, people of color, veterans and individuals with disabilities.
We are a company built on excellence. We have a culture that values growth, achievement and diversity and a workplace where your voice can be heard.
Benefit eligibility may vary by position. Click here to review the benefits associated with this position.
Aetna takes our candidate's data privacy seriously. At no time will any Aetna recruiter or employee request any financial or personal information (Social Security Number, Credit card information for direct deposit, etc.) from you via e-mail. Any requests for information will be discussed prior and will be conducted through a secure website provided by the recruiter. Should you be asked for such information, please notify us immediately.
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If you were eligible to this vacancy, please give us your resume, with salary requirements and a resume to Aetna.
Interested on this vacancy, just click on the Apply button, you will be redirected to the official website
Apply UM Nurse Consultant Here
This vacancy starts available on: Mon, 22 Jan 2018 21:53:43 GMT