Are you passionate about improving the quality of healthcare for individuals across the country? Do you have a strong background in nursing and a desire to make a positive impact on the healthcare industry? Aetna is seeking a highly skilled and compassionate UM Nurse Consultant to join our team. In this role, you will utilize your clinical expertise to review and analyze medical records and provide recommendations for appropriate and cost-effective care. If you possess strong critical thinking skills, excellent communication abilities, and a commitment to delivering top-notch healthcare services, we encourage you to apply for this exciting opportunity. Join us in our mission to build a healthier world, one patient at a time.
- Review and analyze medical records to determine appropriate and cost-effective care for patients.
- Utilize clinical expertise to make recommendations for treatment plans and care options.
- Collaborate with healthcare providers to ensure the best possible outcomes for patients.
- Stay up-to-date on current healthcare trends, policies, and regulations.
- Maintain accurate and detailed documentation of all patient interactions and care recommendations.
- Communicate effectively with patients, healthcare providers, and other team members.
- Utilize critical thinking skills to identify potential issues and develop solutions.
- Adhere to all ethical and legal standards related to patient care and confidentiality.
- Participate in ongoing education and training to maintain knowledge and skills.
- Contribute to the development and implementation of quality improvement initiatives.
- Act as a resource and mentor for other team members.
- Maintain a positive and professional attitude while promoting a patient-centered approach to care.
- Embrace the mission and values of the organization in all interactions.
- Adhere to all company policies and procedures.
- Continuously strive to improve the quality of healthcare services provided to patients.
Bachelor's Degree In Nursing: A Minimum Of A Bachelor's Degree In Nursing Is Required For The Um Nurse Consultant Position At Aetna. This Educational Background Provides The Necessary Knowledge And Skills In Patient Care, Disease Prevention, And Health Promotion.
Valid Nursing License: A Current And Unrestricted Nursing License Is Essential For This Role. The Um Nurse Consultant Must Be Licensed To Practice In The State Or States Where Aetna Operates.
Previous Experience In Utilization Management: Aetna Requires At Least 3-5 Years Of Experience In Utilization Management Or A Related Field For The Um Nurse Consultant Position. This Experience Ensures That The Candidate Is Familiar With The Processes And Procedures Involved In Reviewing And Approving Medical Services.
Strong Communication And Interpersonal Skills: As A Um Nurse Consultant, Effective Communication Is Crucial In Collaborating With Healthcare Providers And Members To Ensure Appropriate And Efficient Use Of Medical Resources. Strong Interpersonal Skills Are Also Necessary For Building Relationships With Team Members And External Stakeholders.
Knowledge Of Healthcare Regulations And Guidelines: Aetna Seeks Candidates Who Have A Thorough Understanding Of Healthcare Regulations And Guidelines, Such As Medicare And Medicaid, As Well As Accreditation Standards. This Knowledge Is Essential In Making Clinical Decisions And Ensuring Compliance With Regulatory Requirements.
Data Analysis
Communication
Time Management
Chronic disease management
Case management
Collaboration
Problem-Solving
Utilization management
Patient Advocacy
Clinical Knowledge
Telephonic Assessment
Communication
Conflict Resolution
Customer Service
Leadership
Time management
creativity
flexibility
Teamwork
Adaptability
Problem-Solving
According to JobzMall, the average salary range for a UM Nurse Consultant in Texas, USA is between $60,000 and $90,000 per year. However, this can vary depending on factors such as experience, location, and the specific company or healthcare facility. It is recommended to research specific job listings and companies for more accurate salary information.
Apply with Video Cover Letter Add a warm greeting to your application and stand out!
Aetna Inc. is an American managed health care company that sells traditional and consumer directed health care insurance and related services, such as medical, pharmaceutical, dental, behavioral health, long-term care, and disability plans, primarily through employer-paid (fully or partly) insurance and benefit programs, and through Medicare. Since November 28, 2018, the company has been a subsidiary of CVS Health.
Get interviewed today!
JobzMall is the world‘ s largest video talent marketplace.It‘s ultrafast, fun, and human.
Get Started