Monday , May 27 2024

Aetna Careers – UM Nurse Associate

Website Aetna

Job Description:

At Aetna, a CVS Health company, we are joined in a common purpose: helping people on their path to better health. We are working to transform health care through innovations that make quality care more accessible, easier to use, less expensive and patient-focused. Working together and organizing around the individual, we are pioneering a new approach to total health that puts people at the heart.

Job Responsibilities:

  • Requires LPN with unrestricted active license. Promotes/ supports quality effectiveness of healthcare services and benefit utilization.
  • Identifies members for referral opportunities to integrate for products, services, and/ or programs.
  • Utilizes clinical experience, criteria/ guidelines, policies and procedures in support of making timely and accurate medical necessity/ benefit determination.
  • Collects information to support the process of rendering appropriate medical necessity/ benefit determinations.
  • Utilizes clinical skills to support the coordination, documentation and communication of medical services and/ or benefit administration determinations.

Job Requirements:

  • Associate Degree or equivalent experience
  • LPN with current unrestricted state licensure required.
  • 2+ years managed care experience preferred
  • Microsoft Office Suite experience preferred.
  • 2+years clinical experience required.
  • acute care experience preferred

Job Details:

Company: Aetna

Vacancy Type:  Full Time

Job Location: Baton Rouge, LA, US

Application Deadline: N/A

Apply Here