Aetna UM Nurse Consultant in Princeton, New Jersey

Req ID: 48078BR


Nurse consultant will Focus on auditing approval and denial letters, focusing on compliance, accuracy and timeliness. Consultant will review clinical notes and requests and make determinations based on clinical guidelines and medical necessity.

Fundamental Components:

Nurse consultants will multitask, focusing on approval and denial letter auditing . The consultant will also review requests for member services and make determinations based on medical evidence based guidelines and criteria. 4748


3+ years of clinical experience required

Must be comfortable working over the computer throughout the day and navigating through multiple platforms

Must be comfortable multitasking

Managed Care experience preferred

Utilization Review experience is a plus


The minimum level of education desired for candidates in this position is a Bachelor's degree or equivalent experience.


Nursing / Registered Nurse (RN) is required


Functional - Nursing/Medical-Surgical Care/3+ Years


Aetna provides the opportunity for professional growth.

Aetna is about more than just doing a job. This is our opportunity to re-shape healthcare for America and across the globe. We are developing solutions to improve the quality and affordability of healthcare. What we do will benefit generations to come.

We care about each other, our customers and our communities. We are inspired to make a difference, and we are committed to integrity and excellence.

Together we will empower people to live healthier lives.

Aetna is an equal opportunity & affirmative action employer. All qualified applicants will receive consideration for employment regardless of personal characteristics or status. We take affirmative action to recruit, select and develop women, people of color, veterans and individuals with disabilities.

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.

Benefit eligibility may vary by position. Click here to review the benefits associated with this position.

Aetna takes our candidate's data privacy seriously. At no time will any Aetna recruiter or employee request any financial or personal information (Social Security Number, Credit card information for direct deposit, etc.) from you via e-mail. Any requests for information will be discussed prior and will be conducted through a secure website provided by the recruiter. Should you be asked for such information, please notify us immediately.

Job Function: Health Care