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 careers-trivia.com
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