Aetna UM Nurse Consultant in Downers Grove, Illinois

Req ID: 39200BR

POSITION SUMMARY

Utilizes clinical skills to coordinate, document and communicate all aspects of the utilization/benefit management program.

Requires an RN with unrestricted active license.

Downers Grove location

Weekend rotation Saturday and Sunday

Ability to multitask/prioritize workload/attend CMO rounds/adapt to fast paced environment

Fundamental Components:

Gathers clinical information and applies the appropriate clinical criteria/guideline, policy, procedure and clinical judgment to render coverage determination/recommendation along the continuum of care.

Communicates with providers and other parties to facilitate care/treatment

Consults and lends expertise to other internal and external constituents in the coordination and administration of the utilization/benefit management function

BACKGROUND/EXPERIENCE desired:

Managed Care experience preferred

3-5 years of clinical experience required

EDUCATION

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 (RN) is required

ADDITIONAL JOB INFORMATION

Exposure to various clinical reviews

Joining a team of highly motivated clinicians

Exposure to multidisciplinary rounds

Avenues for internal growth/leadership opportunities

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