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Concurrent Review Nurses
St. Louis, Kansas City, Columb, MO 63146 United States
Concurrent Review Nurses
St. Louis, Kansas City, Columbia, MO
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.
At Missouri Care, an Aetna Health Plan our nurses make it possible for our members to receive the right health care treatment for their needs and for our company to improve the efficiency of clinical programs and operations. We are recruiting for a Concurrent Review Nurses in St. Louis, Kansas City and Columbia. The positions in St. Louis and Kansas City will visit area hospitals and candidates must be within commuting distance of these cities. Candidates will work from home conducting telephonic reviews when not on site. The opening in Columbia is an office based position. We are not offering work at home for this position.
Missouri Care Health Plan is a MO HealthNet managed care health plan that serves 54 counties in Eastern, Central and Western Missouri. Our mission is to provide access to quality health care for the members we serve. Missouri Care provides coverage for all MO HealthNet programs including MO HealthNet for Kids, MO HealthNet for Pregnant Women and MO HealthNet for Families.
As a Concurrent Review Nurse you will utilize your clinical skills to facilitate and coordinate services for Aetna members that are hospitalized in acute, skilled and long term care settings. You will telephonically review inpatient hospital admissions and assist with the coordination of discharge planning needs. You will obtain the information necessary to assess a member's clinical condition, identify ongoing clinical care needs and ensure that members receive services in the most optimal setting to effectively meet their needs. You will collaborate with physician and hospital personnel to facilitate and coordinate care needs across the continuum of care.
This role allows highly skilled Registered Nurses to reach individuals and influence their healthcare outcomes. This nurse needs to be highly organized, effective in time management, comfortable having his/her work measured, and have strong keyboard and telephone skills.
Concurrent Review/Utilization Review Nurse
Concurrent Review/Discharge Planning experience/1-3 Years
Nursing/Medical-Surgical Care/3-5 Years
Registered Nurse License (RN) is required. License must be current and unrestricted
The highest level of education desired for candidates in this position is a Bachelor's degree or equivalent experience.
Three to five years of recent clinical experience in an acute hospital, skilled nursing, or rehabilitation setting
Medicaid experience preferred
Knowledge of managed care preferred
ADDITIONAL REQUIRED SKILLS
Strong written, verbal and interpersonal skills
Strong time management and organizational skills
Ability to exercise independent sound judgment in decision making utilizing all relevant information
Ability to adjust quickly to changes in workflows and priorities a must
Microsoft Outlook knowledge and experience
We value leadership, creativity and initiative. If you share those values and a commitment to excellence and innovation, consider a career with Aetna. Visit us online at www.Aetna.com/working.
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
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