Aetna UM Nurse Consultant in Tampa, Florida
Req ID: 41889BR
UM Nurse who utilizes clinical skills to coordinate, document and communicate all aspects of the utilization management program. Requires an RN with unrestricted active license
The work setting is a fast paced, and requires the ability to manage multiple priorities. This RN works collaboratively 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 to achieve optimum length of stay for members; the early identification of continuing care needs to facilitate 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
Managed Care experience preferred
3-5 years of clinical experience required
The highest level of education desired for candidates in this position is a Associate's degree or equivalent experience.
LICENSES AND CERTIFICATIONS
Nursing/Registered Nurse is desired
Functional - Nursing/Concurrent Review/discharge planning/1-3 Years
Functional - Nursing/Medical-Surgical Care/1-3 Years
Technical - Operating Systems/Windows/1-3 Years/End User
Benefits Management/Interacting with Medical Professionals/ADVANCED
Benefits Management/Maximizing Healthcare Quality/FOUNDATION
General Business/Consulting for Solutions/FOUNDATION
Leadership/Collaborating for Results/ADVANCED
Service/Providing Solutions to Constituent Needs/ADVANCED
Option for telework will be evaluated after a certain period of employment
ADDITIONAL JOB INFORMATION
This postion location is the Jacksonville, Tampa or Fort Lauderdale area of Florida
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