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Utilization Management Nurse Consultant

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<p>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.</p><p>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.</p>

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Common Interview Questions And Answers

1. HOW DO YOU PLAN YOUR DAY?

This is what this question poses: When do you focus and start working seriously? What are the hours you work optimally? Are you a night owl? A morning bird? Remote teams can be made up of people working on different shifts and around the world, so you won't necessarily be stuck in the 9-5 schedule if it's not for you...

2. HOW DO YOU USE THE DIFFERENT COMMUNICATION TOOLS IN DIFFERENT SITUATIONS?

When you're working on a remote team, there's no way to chat in the hallway between meetings or catch up on the latest project during an office carpool. Therefore, virtual communication will be absolutely essential to get your work done...

3. WHAT IS "WORKING REMOTE" REALLY FOR YOU?

Many people want to work remotely because of the flexibility it allows. You can work anywhere and at any time of the day...

4. WHAT DO YOU NEED IN YOUR PHYSICAL WORKSPACE TO SUCCEED IN YOUR WORK?

With this question, companies are looking to see what equipment they may need to provide you with and to verify how aware you are of what remote working could mean for you physically and logistically...

5. HOW DO YOU PROCESS INFORMATION?

Several years ago, I was working in a team to plan a big event. My supervisor made us all work as a team before the big day. One of our activities has been to find out how each of us processes information...

6. HOW DO YOU MANAGE THE CALENDAR AND THE PROGRAM? WHICH APPLICATIONS / SYSTEM DO YOU USE?

Or you may receive even more specific questions, such as: What's on your calendar? Do you plan blocks of time to do certain types of work? Do you have an open calendar that everyone can see?...

7. HOW DO YOU ORGANIZE FILES, LINKS, AND TABS ON YOUR COMPUTER?

Just like your schedule, how you track files and other information is very important. After all, everything is digital!...

8. HOW TO PRIORITIZE WORK?

The day I watched Marie Forleo's film separating the important from the urgent, my life changed. Not all remote jobs start fast, but most of them are...

9. HOW DO YOU PREPARE FOR A MEETING AND PREPARE A MEETING? WHAT DO YOU SEE HAPPENING DURING THE MEETING?

Just as communication is essential when working remotely, so is organization. Because you won't have those opportunities in the elevator or a casual conversation in the lunchroom, you should take advantage of the little time you have in a video or phone conference...

10. HOW DO YOU USE TECHNOLOGY ON A DAILY BASIS, IN YOUR WORK AND FOR YOUR PLEASURE?

This is a great question because it shows your comfort level with technology, which is very important for a remote worker because you will be working with technology over time...

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