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JOB MISSION SUMMARY
The dedication of talented and caring health care professionals drives the delivery of high quality, cost effective products and services. They make it possible for members to get the right health care treatment for their needs and for Aetna to keep its competitive edge.
RESPONSIBILITIES:
As an Inpatient Care Nurse Consultant you will be responsible for:
-Responsible for managing patients in our Dedicated Unit with concurrent review, precertification, and proactive discharge planning.
-Being patient advocates who strive for excellent customer service while facilitating the appropriate inpatient healthcare management, effective discharge planning and aftercare for our members.
-Planning, implementing, coordinates, monitors, and evaluates the care options and services that will lead to the best outcomes for our members.
-Collection and interpretation of clinical information from practitioners and facilities concerning the care being provided to the member
-Assessment of a members' clinical condition and ongoing medical services and treatments to determine medical appropriateness; guiding the setting for medical intervention to achieve optimum length of stay for members
-Early identification of continuing care needs to facilitate members' discharge planning needs.
- Effectively participating in a multi-disciplinary team as well as functioning individually
REQUIREMENTS
REQUIRED SKILLS/EXPERIENCE:
-Registered nurse with current and unrestricted state license and a minimum of 3-5 years clinical experience.
-Managed care, utilization review and/or case management experience a plus.
-A strong clinical background, sound assessment and decision making skills, creativity, and flexibility are essential
-Ability to exercise independent and sound judgment in decision making, superior interpersonal skills and effective verbal and written communication abilities.
-Organizational skills, effective time management, ability to manage multi
-Computer literacy to navigate through internal and external computer systems.
- Possess a great work ethic and self-motivation.
COMPANY
Aetna , PAUNITED STATES
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