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UM Delegation Oversight RN - Work at Hom
- Work at Home Jobs, Work from Home Jobs
Applicant Category: Professional
Requisition Code: Work at Home
Two Initials of Recruiter: WH
System Date: 10/30/2006
System Time: 09:24:43
Document Name(40): UM Delegation Oversight RN - Work at Hom
Source: Americas Job Bank - USA
SearchTerms: "work at home" "work from home"
URL(80): http://www.jobsearch.org/seeker/jobsearch/keyword?action=JobSearchViewJob&JobSea
Company Job ID:
13045
Job Title:
UM Delegation Oversight RN - Work at Home
Company:
Aetna
Location:
US - CA, Santa Ana, 92705
AJB Reference Number:
35308236
Job Start/End Date:
not provided
Job Type:
Regular
Job Classification :
Full Time
Hours/Week:
not provided
Salary Range:
not provided
Education:
not provided
Required Degree/
Formal Training:
not provided
Required Licenses/
Certificates :
not provided
Experience:
not provided
Company
Homepage:
http://www.aetna...
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Job Description
JOB RESPONSIBILITIES
This job is a Work-At-Home position, however we would prefer an employee who resides somewhere between Irvine, CA and Woodland Hills, CA.
As a UM Delegation Oversight Nurse Consultant you will utilize your written and verbal communication skills, your clinical experience and organizational skills to coordinate regulatory compliance oversight of Aetna s contracted medical groups delegated to perform UM functions for Aetna's HMO and Medicare membership. You will have a working knowledge of California Department of Managed Health Care (DMHC) regulations, Federal ERISA regulations, National Committee for Quality Assurance (NCQA) standards and guidelines and Centers for Medicare Services (CMS) standards. You will perform site audits to assess delegated medical groups compliance with industry standards and regulations and act as a resource to your UM Manager contacts at the delegated medical groups to follow up on identified opportunities for improvement.
SKILL OR EXPERIENCE REQUIREMENTS
Candidates must be a Registered Nurse with an active CA license, must have a minimum of 3 years clinical experience in an acute care setting, and preferably have experience in delegation oversight or in a delegated Medical Group HMO environment.
Candidates must have understanding of current NCQA MCO standards and guidelines and must have the ability to exercise sound judgment, possess critical thinking capabilities and be flexible.
A high degree of comfort with computer software programs in a windows environment is essential.
ADDITIONAL JOB INFORMATION
Candidate will attend 2-4 weeks of paid training in Walnut Creek, CA upon hire.Candidate will be required to travel to perform audits approximately 50% of the time, using their personal vehicle. Mileage reimbursement and all necessary work-at-home equipment and services will be provided.
Please note that benefit eligibility may vary by position. Click here to review the benefits associated with this position.
HOW TO APPLY
To learn more about this job opportunity, paste the following link into your web browser's address field:
http://aetna.recruitmax.com/ENG/candidates/default.cfm?szCategory=jobprofile&szOrderID=13045&
We conduct pre-employment drug and background testing.
No agencies, please.
Aetna is an equal opportunity/affirmative action employer.
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