Inpatient Care Nurse Consultant

Inpatient Care Nurse Consultant

 

JOB RESPONSIBILITIES:
As an integral member of the Care Management Team, the Inpatient Care Coordinator is responsible for providing comprehensive healthcare management services to facilitate appropriate health care treatment, effectively manage health care costs and improve health care program/operational efficiency involving clinical issues. These responsibilities will be accomplished thought the following activities:
-Review of targeted cases in acute care facilities for medical necessity for admission, continued stay and discharge stability utilizing nationally recognized criteria.
-Proactive facilitation and development of the discharge plan, verification that appropriate services are in place and coordination of additional services as necessary within plan benefits.
-Perform preadmission and post discharge follow up calls for selected cases.
-Manage members transferred to SNF, Rehab or Long Term Care Facility from the acute inpatient setting.
-Screen patients for Case Management and Disease Management needs. Collaborate with Care Team members and Medical Directors in case rounds and case conferences to assist in managing the member through the continuum of care.
-Function as an integral part of the Care Management Team with accountability for team outcomes and success and for meeting and exceeding performance metrics.

SKILL OR EXPERIENCE REQUIREMENTS:
The candidate must be a Registered Nurse with current state license and a minimum of three years recent clinical nursing experience. Advance degree/certification preferred, e.g. BSN, CRRN, CIRS, CCM, MSN, etc. In addition, the successful candidate will have:
-Superior interpersonal and negotiation skills to effectively establish positive relationships with employees, customers, providers and team members.
-Ability to exercise independent and sound judgment in decision making, utilizing all relevant information.
-Strong verbal and written communication skills, effective time management and organizational skills.
-Ability to manage multiple priorities, flexibility and adaptability to a changing and challenging work environment.
-Strong teamwork skills; i.e., takes initiative to share knowledge with team members, willingly offers assistance.
-Experience working in a Managed Care environment or previous Utilization Management or Discharge Planning experience is preferred.

ADDITIONAL JOB INFORMATION: 
You will be working in a team environment with Patient Management professionals in the Southeast Region. The successful candidate will be responsible for utilization management for Aetna Health, Inc. members. Training to the Aetna Health, Inc. systems and products will be provided.

 

HOW TO APPLY:

To learn more about our employment opportunities, visit us at www.aetna.com and enter Requisition #12252 on the job search page.

 

We conduct pre-employment drug and background testing.

No agencies, please.

Aetna is an equal opportunity/affirmative action employer.