Utilization Management Nurse Consultant – Amazon Store

Remote, USA Full-time
September 9, 2025 Are you a compassionate and driven registered nurse with a passion for helping others? Do you have experience in utilization management and a desire to use your skills to make a positive impact on people's lives? If so, Aetna is seeking a Utilization Management Nurse Consultant to join our team. In this role, you will have the opportunity to work closely with patients, physicians, and other healthcare professionals to ensure the most efficient and effective use of healthcare resources. We are looking for a highly motivated individual with exceptional critical thinking and communication skills, as well as a thorough understanding of healthcare regulations and guidelines. If you are ready to take your nursing career to the next level and make a meaningful difference in the healthcare industry, we encourage you to apply for this exciting opportunity. Conduct utilization management activities to ensure appropriate use of healthcare resources. Collaborate with patients, physicians, and other healthcare professionals to develop and implement individualized care plans. Review and analyze medical records to identify opportunities for improved patient care and cost savings. Communicate with insurance providers to obtain pre-authorization for medical procedures and treatments. Monitor and track patient progress and treatment plans to ensure optimal outcomes. Educate patients and their families on healthcare options and available resources. Stay up-to-date on healthcare regulations and guidelines to ensure compliance. Utilize critical thinking skills to make informed decisions on patient care and resource allocation. Document all interactions and interventions accurately and timely. Participate in team meetings and contribute ideas for process improvement. Act as a resource and support for other healthcare professionals. Maintain patient confidentiality and adhere to ethical standards. Continuously evaluate and adjust utilization management processes to improve efficiency and effectiveness. Provide guidance and training to new team members. Represent the company in a professional and compassionate manner at all times. Aetna is an Equal Opportunity Employer. We celebrate diversity and are committed to creating an inclusive environment for all employees. We do not discriminate based upon race, religion, color, national origin, sex, sexual orientation, gender identity, age, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics. apply to this job

Apply Now

Similar Jobs

Registered Nurse RN Urgent Care – Amazon Store

Remote, USA Full-time

Registered Nurse – Urgent Care – Amazon Store

Remote, USA Full-time

Registered Nurse (RN) - 11LM Med/Tele .9, 7P – Amazon Store

Remote, USA Full-time

Registered Nurse (RN), Vascular Access – Amazon Store

Remote, USA Full-time

Registered Nurse (RN) Vascular Access – Amazon Store

Remote, USA Full-time

Registered Nurse (RN) - Vascular Access Team, Children's & Women's Hos – Amazon Store

Remote, USA Full-time

Nurse Practitioner-in-person and remote/telehealth – Amazon Store

Remote, USA Full-time

Overnight Telemedicine Nurse Practitioner – Amazon Store

Remote, USA Full-time

SAP HCM Payroll Consutalant - Avance Consulting

Remote, USA Full-time

Nurse Practitioner (Remote, Urgent Care) – Amazon Store

Remote, USA Full-time

Региональный медицинский советник/Medical Scientific Liaison

Remote, USA Full-time

Student Intern, Graphic Design - 8-Week Summer Program with Foundation for California Community Colleges

Remote, USA Full-time

Netflix (Data Entry, Entry Level) $70K-80K$/Year

Remote, USA Full-time

Part-Time Remote Customer Service Associate - Online Chat

Remote, USA Full-time

**Experienced Full Stack Data Entry Specialist – Sports Information Management and Data Analysis**

Remote, USA Full-time

Experienced Data Entry Operator – Detail-Oriented and Organized Professional for Dynamic Brooklyn Team

Remote, USA Full-time

American Express Customer Service Remote Jobs – Apply Now

Remote, USA Full-time

Food Manager

Remote, USA Full-time

Care Manager

Remote, USA Full-time

Assistant Faculty in Computer Information Systems - Online Education - Part-Time Remote Opportunity with Competitive Salary

Remote, USA Full-time
Back to Home