At Aetna, a CVS Health Company, we’re pioneering a total approach to health and wellness, focusing on the whole person - body, mind, and spirit. Our more than 4,000 nurses are central to turning our member’s health ambitions, big and small, into achievements. Your role will include helping members stay well, manage health conditions, and access the right care at the right time. As you do this, we’ll support you in achieving more in your life and your work.
What makes a successful nurse? Here are the traits we are looking for:
- Problem Solver
- Results Driven
- Technology Savvy
- Detail Oriented
- Good Listener
- Open Minded
- Team Player
Paid Time Off & Disability
Prior Authorization Nurse LPN/LVN Texas Star KidsPrimary Location: Dallas, Texas
Additional Locations: TX-Dallas Apply
This position will be working out of the 2777 Stemmons Freeway location in Dallas TX.
At Aetna Better Health of Texas, we are committed to helping people on their path to better health. By taking a total and connected approach to health, we guide and support our members so they can get more out of life, every day. We are looking for people like you who value excellence, integrity, caring and innovation. As an employee, you’ll join a team dedicated to improving the lives of Texas STAR Kids members. We value diversity and are dedicated to helping you achieve your career goals.
Utilizes clinical skills to support the coordination, documentation and communication of medical services and/or benefit administration determinations. Requires LPN/LVN with unrestricted active license.
71040Fundamental Components: Promotes/supports quality effectiveness of Healthcare Services and benefit utilization Utilizes clinical skills to support coordination, documentation and communication of medical services and/or benefit administration Collects information to support the process of rendering appropriate medical necessity/benefit determinations Identifies members for referral opportunities to integrate with other products, services and/or programs Utilizes clinical experience, criteria/guidelines, policies and procedures in support of making timely and accurate medical necessity/benefit determinations Background Experience:
- 3+ years clinical experience required. (Required)
- LPN/LVN with current unrestricted state licensure required. (Required)
- 2+ years managed care experience. (Preferred)
- Pediatric/Adolescent experience preferred
- Ability to multitask, prioritize and effectively adapt to a fast paced changing environment.
- Position requires proficiency with computer skills which includes navigating multiple systems and keyboarding
- Effective communication skills, both verbal and written.
- Computer literacy and demonstrated proficiency is required in order to navigate through internal/external computer systems, and MS Office Suite applications, including Word and Excel. Strong keyboard and mouse skills required.
- Ability to effectively participate in a multi-disciplinary team including internal and external participants
- Typical office working environment with productivity and quality expectations.
- Work requires the ability to perform close inspection of handwritten and computer- generated documents as well as a PC monitor.
- Sedentary work involving periods of sitting, talking, listening.
- Work requires sitting for extended periods, talking on the telephone and typing on the computer.
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