Registered Nurse (RN) - Remote Utilization Management Nurse Consultant
Location: Aberdeen South Dakota
Description: Aetna is currently interviewing Registered Nurse (RN) - Remote Utilization Management Nurse Consultant right now, this occupation will be placed in South Dakota. More complete informations about this occupation opportunity please read the description below. This position is with American Health Holding (AHH). Telecommuters must have a separate ! dedicated area for HIPPA compliance. The candidate will be working on a phone and with a computer.
There are two openings available, one with hours that are 10:30 AM - 7:00 PM ET, and the other with hours that are 9:30 AM - 6:00 PM ET.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.
- Requires at least fives years acute hospital care.
- Clinical is processed against approved criteria.
- All aspects of the utilization process (including precertification, concurrent and retro reviews and discharge planning) require adherence to URAC standards, various laws and regulations and company policies and procedures.
- The UM nurse consultant needs to be highly organized, effective in time management, ability to manage multiple priorities, have strong teamwork skills, comfortable h! aving his/her work measured, and have strong keyboard and tele! phone skills.
The highest level of education desired for candidates in this position is a Bachelor's degree or equivalent experience.
LICENSES AND CERTIFICATIONS
Nursing/Registered Nurse (RN) is required
FUNCTIONAL EXPERIENCES
Functional -Nursing/Medical-Surgical Care/3+ YearsFunctional - Utilization Review/Utilization Management/1-3 Years
Functional - Nursing/Oncology/1-3 Years
REQUIRED SKILLS
Technology/Leveraging Technology
General Business/Turning Data into Information
Benefits Management/Interacting with Medical Professionals
DESIRED SKILLS
Benefits Management/Maximizing Healthcare Quality
Aetna does not permit the use of tobacco related products or drugs in the workplace.
Job Function: Health Care
- .
If you were eligible to this occupation, please email us your resume, with salary requirements and a resume to Aetna.
If you interested on this occupation just click on the Apply button, you will be redirected to the official website
This occupation starts available on: Thu, 11 Jul 2013 01:12:09 GMT
Apply Registered Nurse (RN) - Remote Utilization Management Nurse Consultant Here