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Utilization Management Nurse Associate
•30 days ago
| Hours | Full-time, Part-time |
|---|---|
| Location | Omaha, Nebraska |
About this job
This is an in-office role based out of Omaha, NE.
An LPN license is required.
POSITION SUMMARY
This position requires use of critical nursing experience and skills to determine the medical necessity for medical services. This is a telephonic position.
This position requires good telephonic communication skills. The position requires a candidate who will receive medical information telephonically or via fax and then applies criteria to determine the medical necessity of medical services.
BACKGROUND/EXPERIENCE
-2 years managed care experience is desired
-2 plus years 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/Licensed Practical Nurse (LPN) is required
FUNCTIONAL EXPERIENCES
Nursing//1-3 Years
REQUIRED SKILLS
Benefits Management/Maximizing Healthcare Quality
General Business/Applying Reasoned Judgment
General Business/Maximizing Work Practices
DESIRED SKILLS
Leadership/Collaborating for Results
Leadership/Driving a Culture of Compliance
Service/Providing Solutions to Constituent Needs
Telework Specifications:
Option for telework will be evaluated after a certain period of employment/proficiency in job duties.
ADDITIONAL JOB INFORMATION
This position provides the opportunity to impact the health of individuals through efficient use of their medical benefits. 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. We conduct pre-employment drug and background testing. Benefit eligibility may vary by position. Click here to review the benefits associated with this position. Employment Type Regular Career Band Description Business Support & Technical
An LPN license is required.
POSITION SUMMARY
This position requires use of critical nursing experience and skills to determine the medical necessity for medical services. This is a telephonic position.
This position requires good telephonic communication skills. The position requires a candidate who will receive medical information telephonically or via fax and then applies criteria to determine the medical necessity of medical services.
BACKGROUND/EXPERIENCE
-2 years managed care experience is desired
-2 plus years 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/Licensed Practical Nurse (LPN) is required
FUNCTIONAL EXPERIENCES
Nursing//1-3 Years
REQUIRED SKILLS
Benefits Management/Maximizing Healthcare Quality
General Business/Applying Reasoned Judgment
General Business/Maximizing Work Practices
DESIRED SKILLS
Leadership/Collaborating for Results
Leadership/Driving a Culture of Compliance
Service/Providing Solutions to Constituent Needs
Telework Specifications:
Option for telework will be evaluated after a certain period of employment/proficiency in job duties.
ADDITIONAL JOB INFORMATION
This position provides the opportunity to impact the health of individuals through efficient use of their medical benefits. 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. We conduct pre-employment drug and background testing. Benefit eligibility may vary by position. Click here to review the benefits associated with this position. Employment Type Regular Career Band Description Business Support & Technical
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