Licensed Behavioral Health Utilization Management (UM)

At aetna we are committed to ensure that our members receive the best, most appropriate care. As a Utilization Management (UM) Nurse Clinician, you will work in a fast paced, autonomous, team oriented environment where turn around times and meeting deadlines are critical.

Fundamental Components:

Utilizes clinical skills to coordinate, document and communicate all aspects of the utilization/benefit management program. Applies critical thinking and is knowledgeable in clinically appropriate treatment, evidence based care and clinical practice guidelines for Behavioral Health and/or medical conditions based upon program focus.

BACKGROUND/EXPERIENCE desired:

3+ years years of direct clinical practice experience: must have behavioral/mental health experience, chemical dependency and/or eating disorder experience in the past. It is highly preferred your experience includes inpatient settings.

Position requires proficiency with computer skills which includes navigating multiple systems and keyboarding.

Ideal candidates will have mental health, chemical dependency, and/or eating disorder experience.

Education

The minimum 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 OR

Social Worker/Licensed Clinical Social Worker (LCSW) is required OR

Social Worker/Licensed Professional Counselor (LPC) is required OR

Social Worker/Marriage and Family Therapist License (M&FT) is required

Mental Health/Certified Addiction Counselor (CAC) is desired

Mental Health/Licensed Mental Health Counseler is desired

Mental Health/Licensed Social Worker is desired

Functional Experiences

Functional - Nursing/Mental Health/4-6 Years
Functional - Clinical / Medical/Concurrent review / discharge planning/1-3 Years
Functional - Clinical / Medical/Direct patient care (hospital, private practice)/4-6 Years

Technology Experiences

Technical - Desktop Tools/Microsoft Outlook/1-3 Years/System Support
Technical - Desktop Tools/Microsoft Word/1-3 Years/System Support

REQUIRED SKILLS
Benefits Management/Understanding Clinical Impacts/FOUNDATION
General Business/Consulting for Solutions/ADVANCED
Leadership/Collaborating for Results/FOUNDATION

Desired Skills

Benefits Management/Encouraging Wellness and Prevention/ADVANCED
Benefits Management/Interacting with Medical Professionals/ADVANCED
General Business/Communicating for Impact/FOUNDATION

Telework Specifications:
Full-Time Telework (WAH)

Considered for any US location; training period in the office may be required

Additional Job Information

Aetna is about more than just doing a job. This is our opportunity to re-shape healthcare for America and across the globe. We are developing solutions to improve the quality and affordability of healthcare. What we do will benefit generations to come.

We care about each other, our customers and our communities. We are inspired to make a difference, and we are committed to integrity and excellence.

Together we will empower people to live healthier lives.

Aetna is an equal opportunity & affirmative action employer. All qualified applicants will receive consideration for employment regardless of personal characteristics or status. We take affirmative action to recruit, select and develop women, people of color, veterans and individuals with disabilities.

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.

We conduct pre-employment drug and background testing. Benefit eligibility may vary by position. Click here to review the benefits associated with this position.

Employment Type Regular Career Band Description Professional.