Registered Nurse (RN) - Oral Maxillofacial Surgery (OMFS) Quality Management Nurse Consultant vacancy at Aetna in Blue Bell

Aetna is currently seeking to employ Registered Nurse (RN) - Oral Maxillofacial Surgery (OMFS) Quality Management Nurse Consultant on Tue, 09 Apr 2013 08:01:30 GMT. Oral Maxillofacial Surgery is looking to add to their team of clinicians. We are looking for an individual with an orthognathic background.POSITION SUMMARY 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...

Registered Nurse (RN) - Oral Maxillofacial Surgery (OMFS) Quality Management Nurse Consultant

Location: Blue Bell Pennsylvania

Description: Aetna is currently seeking to employ Registered Nurse (RN) - Oral Maxillofacial Surgery (OMFS) Quality Management Nurse Consultant right now, this vacancy will be placed in Pennsylvania. More details about this vacancy opportunity please read the description below. Oral Maxillofacial Surgery is looking to add to their te! am of clinicians. We are looking for an individual with an orthognathic background.POSITION SUMMARY
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. Requires an RN with unrestricted active license.

EDUCATION
The highest level of education desired for candidates in this position is a Bachelor's degree or equivalent experience.

LICENSES AND CERTIFICATIONS
Nursing/Registered Nurse (RN) is required

FUNCTIONAL EXPERIENCES
Functional - Nursing/Clinical coverage and policies/1-3 Years
Functional - Clinical/Medical/Clinical claim review & coding/1-3 YearsFunctional - Assisting! with Oral Surgery/1-3 YearsTECHNOLOGY EXPERIENCES
Technic! al - Aetna Applications/Aetna Total clinical View/1-3 Years

REQUIRED SKILLS
Benefits Management/Understanding Clinical Impacts
General Business/Applying Reasoned Judgment
Leadership/Fostering a Global Perspective

DESIRED SKILLS
Technology/Leveraging Technology
Benefits Management/Interacting with Medical Professionals
Please note that benefit eligibility may vary by position. Clickhereto review the benefits associated with this position.

Aetna does not permit the use of tobacco related products or drugs in the workplace.

Job Function: Health Care
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If you were eligible to this vacancy, please email us your resume, with salary requirements and a resume to Aetna.

If you interested on this vacancy just click on the Apply button, you will be redirected to the official website

This vacancy starts available on: Tue, 09 Apr 2013 08:01:30 GMT

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