Part time job Aetna RN Remote Jobs, Aetna Careers Work From Home RN

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This Utilization Management (UM) Nurse Consultant position is completely remote and workers can stay in any nation.

Normal Working Hours:

8:30 am-5:00 pm in the time area of residence. Shift instances may also range once in a while in keeping with the want of the department.
There is an overdue shift requirement till 9:00 pm EST about three instances in keeping with the year.
There is a weekend shift requirement in keeping with the desires of the team.
Holiday rotation in keeping with the want of the department (generally 1 excursion in keeping with the year).

There isn’t anyt any journey predicted with this function.

As a Utilization Management Nurse Consultant, you’ll make use of medical abilities to coordinate, report and speak all elements of the utilization/gain control application. You could be accountable for making sure the member is receiving the proper care at the proper time and at the proper location, at the same time as adhering to federal and nation-regulated turn-round instances. This consists of reviewing written medical records.

The UM Nurse Consultant process obligations include (now no longer all-encompassing):

Reviews offerings to guarantee clinical necessity, applies medical information to guarantee suitable gain utilization, helps secure and green discharge-making plans and works intently with centers and companies to fulfill the complicated desires of the member.
Utilizes medical abilities to coordinate, report and speak all elements of the utilization/gain control application.
Utilizes medical experience and abilities in a collaborative method to assess, plan, implement, coordinate, screen and compare alternatives to facilitate suitable healthcare offerings/advantages for participants

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Gathers medical facts and applies the proper medical criteria/guideline, policy, procedure, and medical judgment to render insurance determination/advice alongside the continuum of care
Communicates with companies and different events to facilitate care/treatment
Identifies participants for referral possibilities to combine with different products, offerings and/or programs
Identifies possibilities to sell nice effectiveness of Healthcare Services and gain utilization
Consults and lends information to different inner and outside materials withinside the coordination and management of the utilization/gain control function.

Pay Range

The normal pay variety for this position is:

Minimum: 28.25
Maximum: 60.50

This pay variety represents the bottom hourly price or base annual full-time income for all positions withinside the process grade inside which this function falls. The real base income provided will rely on a range of things which includes experience, education, geography and different applicable factors. This function is eligible for a CVS Health bonus, fee or short-time period incentive application further to the bottom pay variety indexed above.

Required Qualifications

Must have cutting-edge energetic and unrestricted RN licensure in the nation of residence
2+ years of medical experience as an RN (all medical regions considered: Home Health, Med/Surg, Telemetry, ICU, NICU, Long time period care, orthopedics, and more)

Preferred Qualifications

1+ years experience Utilization Review experience
1 + years experience in Managed Care
Strong telephonic conversation abilities
1+ years’ experience with Microsoft Office Suite (PowerPoint, Word, Excel, Outlook)
Experience with computer systems toggling among displays at the same time as the usage of a keyboard and talking to customers.
Ability to workout unbiased and sound judgment, robust decision-making abilities, and well-advanced interpersonal abilities
Ability to control a couple of priorities, powerful organizational and time control abilities required
Ability to use a pc station and take a seat down for prolonged durations of time

Required Education

Associates Degree required; BSN preferred

Responsibilities

Utilization Management Nurse Consultant

Qualifications

Associate Degree

Job Benefits

The Company gives a complete variety of medical, dental, imaginative and prescient benefits. Eligible personnel can also additionally sign up withinside the Company’s 401(k) retirement financial savings plan, and an Employee Stock Purchase Plan is likewise to be had for eligible personnel. The Company gives a fully-paid time period lifestyle coverage plan to eligible personnel, and short-time period and long time incapacity benefits.

CVS Health additionally gives severa wellness applications, training assistance, loose improvement courses, a CVS shop cut price, and cut-price applications with collaborating partners. As for time without work, Company personnel experience Paid Time Off (PTO) or excursion pay, in addition to paid vacations for the duration of the calendar year. A number of paid vacations, unwell time and different times without work are furnished constant with applicable national regulations and Company policies.