Nursing Work From Home Jobs – CLA

DETAILS:

Job Responsibilities: PQOC Nurse Consultant

Hiring Organization: Aetna

Educational Requirements: Associate Degree

Industry: Private

Employment Type: Full Time

Salary: $30 – $40/Hour

Location: Utah, USA

DESCRIPTION

Bring your coronary heart to CVS Health. Everyone folks at CVS Health stock a single, clean reason: Bringing our coronary heart to each second of your fitness. This reason courses our dedication to supplying stronger human-centric fitness to take care of a swiftly converting world. Anchored in our brand — with coronary heart at its center — our reason sends a non-public message that how we supply our offerings is simply as critical as what we supply. Nursing Work From Home Jobs

Our Heart At Work Behaviors™ aid this reason. We need all of us who work at CVS Health to feel empowered with the aid of using the function they play in remodeling our way of life and accelerating our capacity to innovate and supply answers to make fitness care extra non-public, handy and affordable.

Aetna Better Health of Oklahoma, a CVS Health business enterprise, is a depended on fitness associate withinside the neighborhood Oklahoma groups we serve. We offer a complete array of progressive offerings that beautify average wellbeing and enhance regular lifestyles for our members. At Aetna Better Health of Oklahoma, we fee expert improvement and profession growth. You will work alongside different colleagues who align on Heart at Work behaviors and bringing your coronary heart to each second of fitness. We will guide you all of the way! Nursing Work From Home Jobs

Position Summary

This is a complete-time teleworker possibility in any nation (United States). Oklahoma residency is a plus.

Working agenda is Monday-Friday, 8am-5pm (CST) with flexibility to work outdoor of commercial enterprise hours, as needed.

This function reviews to the Potential Quality of Care (PQOC) nurse investigator group manager. This function is answerable for the evaluate and assessment of blanketed scientific facts and documentation.

The PQOC group critiques documentation and translates facts received from scientific statistics or structures to use suitable scientific standards and regulations in step with regulatory and accreditation necessities for member and/or company troubles. Nursing Work From Home Jobs

Fundamental Components

Works Potential Quality of Care cases (Medical and Behavioral Health), along side Patient Safety Events throughout all strains of commercial enterprise (Commercial, Medicare, and Medicaid). Independently coordinates the scientific decision with inner/outside clinician guide as required.
Reviews documentation and evaluates Potential Quality of Care troubles primarily based totally on scientific regulations and gain determinations.
Considers all documented device facts in addition to any extra statistics/facts offered to increase a dedication or recommendation.
Data collecting calls for navigation via a couple of device applications.
Staff can be required to touch the carriers of record, vendors, or inner Aetna departments to attain extra facts.
Evaluates documentation/facts to decide compliance with scientific coverage, regulatory and accreditation guidelines.
Accurately applies important questioning competencies similarly with group primarily based totally choice rubric to guarantee case is reviewed through a practitioner with scientific knowledge for the problem at hand. Nursing Work From Home Jobs
This function instructions a complete know-how of complicated delegation arrangements, contracts (member and company), scientific standards, gain plan structure, regulatory necessities, business enterprise coverage and different techniques that are required to guide the evaluate of the scientific documentation/facts.
Pro-actively and always applies regulatory and accreditation requirements to guarantee that sports are reviewed and processed inside guidelines.
Condenses complicated facts right into a clean and unique scientific photograph even as running independently.
Reports audit or scientific findings to suitable group of workers or others so as to make certain suitable final results and/or follow-up for development as indicated.
The incumbent have to exhibit robust scientific judgement in addition to know-how of inner structures.

Required Qualifications

RN with cutting-edge unrestricted Oklahoma nation licensure or OK “multi-nation privilege” compact nursing license.
3+ years of scientific experience
2+ years’ experience the use of private computer, keyboard navigation, navigating a couple of structures and applications; and the use of MS Office Suite applications (Teams, Outlook, Word, Excel, etc.), Nursing Work From Home Jobs

Preferred Qualifications

Emergency/important care experience
Experience running Grievance cases
Case Management or Utilization Management experience
Managed care experience
Medicaid experience
Behavioral Health experience
Systems experience: ATV, ASD, GPS, MedCompass, QNXT, and Dynamo
Experience running with Regulatory Agencies
Critical questioning competencies, Nursing Work From Home Jobs
Previous experience running in a remote/digital environment

Education

Minimum of Associates or Diploma nursing diploma required
BSN diploma preferred

Pay Range

The usual pay variety for this function is:

$30.00 – $40.00

This pay variety represents the bottom hourly charge or base annual complete-time profits for all positions inside the activity grade inside which this function falls. The real base profits provided will depend upon a selection of things together with experience, schooling, geography and different applicable factors. This function is eligible for a CVS Health bonus, fee or short-time period incentive application similar to the bottom pay variety indexed above. Nursing Work From Home Jobs

About Aetna

Aetna is a healthcare corporation that gives more than a few medical insurance and associated services. Aetna operates as a subsidiary of CVS Health, following a merger finished in 2018. Aetna was based in 1853 in Hartford, Connecticut, because the Aetna Life Insurance Company, initially specialized in life insurance. Over the years, Aetna has changed its services and has become a main participant in the medical insurance and controlled care industries. Nursing Work From Home Jobs

Benefits

In addition to your compensation, experience the rewards of an agency that places our coronary heart into worrying for our colleagues and our communities. The Company provides a complete variety of medical, dental, and imaginative and prescient benefits. Eligible personnel might also additionally sign up inside the Company’s 401(k) retirement financial savings plan, and an Employee Stock Purchase Plan is likewise to be had for eligible personnel. The Company affords a fully-paid period existence coverage plan to eligible personnel, and short-time period and long-time incapacity benefits. CVS Health additionally gives several health applications, schooling assistance, unfastened improvement courses, a CVS save cut price, and cut-price applications with taking part partners. As for break day, Company personnel experience Paid Time Off (“PTO”) or excursion pay, in addition to paid vacations throughout the calendar year. Several paid vacations, unwell time and different break days are furnished constantly with applicable kingdom regulations and Company rules. Nursing Work From Home Jobs

Key Advantages Of Joining Aetna As A Remote Worker

Joining Aetna as a remote employee gives numerous key advantages, reflecting the organization’s dedication to offering a dynamic and inclusive work environment. Some of the first-rate advantages of becoming a member of Aetna as a remote employee include:

Flexibility and Work-Life Balance: Remote work regularly presents extra flexibility in phrases of labor hours and location, permitting personnel to gain a higher work-life balance.
Reduced Commuting Stress: Remote people can keep away from commuting to a bodily workplace, lowering pressure and saving time that might in any other case be spent on transportation.
Access to a Nationwide Talent Pool: Remote work permits agencies like Aetna to faucet right into a broader skills pool, permitting them to draw professional specialists from unique geographic locations.
Technology and Connectivity Support: Companies investing in remote work regularly offer the essential era and guide to make certain remote personnel have the equipment and assets needed to carry out their jobs efficiently.
Cost Savings: Remote work can cause price financial savings for personnel, which include decreased commuting expenses, work apparel costs, and capability financial savings on meals.
Health and Safety: Especially applicable in instances of public fitness concerns, remote work can contribute to worker fitness and protection with the aid of minimizing publicity to workplace-primarily based totally environments.
Increased Productivity: Some people discover that remote work environments can decorate productiveness because of fewer place of business distractions and a greater personalized work setup.
Personalized Work Environment: Remote people can create customized and snug work surroundings tailor-made to their preferences, doubtlessly boosting process satisfaction.
Environmental Impact: Remote work can contribute to a discount on the environmental effect related to commuting because it affects fewer automobiles on the street and much less calls for workplace space.
Employee Wellness Programs: Companies like Aetna can also additionally provide remote personnel get right of entry to well-being packages that guide bodily and intellectual fitness.
Inclusion and Diversity: Remote work can contribute to fostering a greater inclusive place of business with the aid of accommodating people with unique wishes and circumstances.
Remote Collaboration Tools: Companies investing in remote work regularly offer get right of entry to collaboration equipment that facilitates powerful conversation and teamwork amongst remote teams.

Nursing Work From Home Jobs – CLA