Aetna Utilization Management Nurse Associate in Dallas, Texas

Req ID: 39675BR

This is an office based role in Dallas, TX.


Licensed nurse that utilizes clinical skills to support the coordination, documentation and communication of medical services and/or benefit administration determinations.

Fundamental Components include but are not limited to:

-Promotes/supports quality effectiveness of Healthcare Services and benefit utilization

-Utilizes clinical skills to support coordination, documentation and communication of medical services and/or benefit -administration

Collects information to support the process of rendering appropriate medical necessity/benefit determinations

-Identifies members for referral opportunities to integrate with other products, services and/or programs

-Utilizes clinical experience, criteria/guidelines, policies and procedures in support of making timely and accurate medical necessity/benefit determinations


An active and good standing LPN or LVN license is required

2 plus years clinical experience required

2 years managed care experience preferred

2 plus years Prior Authorization experience preferred

Experience with Microsoft Word, Outlook, and Excel is required


The minimum level of education desired for candidates in this position is a Associate's degree or equivalent experience.


An active and good standing LPN or LVN license is required


Medical/Precertification/1-3 Years

Medical-Surgical Care/4-6 Years

Medical Management - Precertification/1-3 Years


Microsoft Word/1-3 Years


General Business/Applying Reasoned Judgment

General Business/Maximizing Work Practices

Benefits Management/Maximizing Healthcare Quality


General Business/Turning Data into Information/FOUNDATION

Service/Providing Solutions to Constituent Needs/FOUNDATION

General Business/Consulting for Solutions/FOUNDATION


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.

Job Function: Health Care