Prior Authorization Nurse (RN)

About Our Company
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.

JOB MISSION SUMMARY

The dedication of talented and caring health care professionals drives the delivery of high quality, cost effective products and services. They make it possible for members to get the right health care treatment for their needs and for Aetna to keep its competitive edge.

RESPONSIBILITIES
-Provides clinical expertise using established criteria reviewing prior authorization requests
-Provides clinical guidance to prior authorization staff and works closely with the health plan medical directors
-Appropriately respond to all requests for authorization of services in accordance with policies
-Independently approve selected services in accordance with policies and established criteria
-Assure integrity of the referral by accurately entering information into the database as indicated
-Serve as a liaison between providers and Medical Director
-Identify issues and problem areas and participates in the development of solutions
-Performs other duties, assignments and responsibilities as assigned or required




Required Skills:
REQUIRED SKILLS
-R.N., Bachelor's Degree preferred
-Three years nursing experience in hospitals, doctor's offices, etc. with exposure to a variety of specialties
-Customer serivce experience required

ADDITIONAL JOB INFORMATION
-Must maintain regular and acceptable attendance
-Must be available to work Monday through Friday from 8am to 5pm

Schaller Anderson is an affiliate of Aetna.  We value leadership, creativity and initiative. If you share those values and a commitment to excellence and innovation, consider a career with our company.

To learn more about this opportunity, visit us at www.aetna.com/working Under requisition # select 23954 and submit your resume.

Please note that benefit eligibility may vary by position. Click here to review the benefits associated with this position.

We conduct pre-employment drug and background testing.
No agencies, please.


We are an equal opportunity/affirmative action employer.