Aetna – New Albany, OH – QM Nurse Consultant
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ABOUT OUR COMPANY
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.
Responsible for the review and evaluation of clinical information and documentation. Reviews documentation and interprets data obtained from clinical records or systems to apply appropriate clinical criteria and policies in line with regulatory and accreditation requirements for member and/or provider issues. Independently coordinates the clinical resolution with internal/external clinician support as required.
To view anAetna Nurse Video andFAQ’s aboutbeinga nurse at Aetna, please go to www.aetna.com, click on’Careers’,’Experienced Professionals’ and Select’Nurses’.
or follow the link below:
ADDITIONAL JOB INFORMATION
This is an office-based position located in New Albany, Ohio.
- Bachelor’s degree or equivalent experience.
LICENSES AND CERTIFICATIONS
- Registered Nurse (RN) is required
- Certified Case Manager (CCM) is desired
FUNCTIONAL WORK EXPERIENCE
- Nursing: Quality Management
- Nursing: Concurrent Review/discharge planning
- Nursing: Clinical coverage and policies
- Nursing: Case Management
- Collaborating for Results
- Turning Data into Information
- Understanding Clinical Impacts
- Maximizing Healthcare Quality
- Leveraging Technology
- Driving a Culture of Compliance
- Interacting with Medical Professionals
We value leadership, creativity and initiative. If you share those values and a commitment to excellence and innovation, consider a career with Aetna.
We conduct pre-employment drug and background testing.
Aetna does not permit the use of tobacco related products or drugs in the workplace. No agencies, please.
Aetna is an Equal Opportunity/Affirmative Action Employer. M/F/D/V
Aetna is committed to maintaining an environment in which all employees are treated equitably and given the opportunity within the context of the business to achieve their potential. Aetna’s Affirmative Action responsibilities extend to women, minorities, persons with disabilities and veterans. Company policy also provides for equal opportunity for qualified individuals regardless of race, color, sex, national origin, religion, age, disability, veteran status, sexual orientation, gender identity or marital status. >>» View or apply to jobNone found.