UM Nurse Consultant - Remote

Overview

The UM Nurse Consultant position at CVS Health involves utilizing clinical skills to assess and coordinate healthcare services for members, working in a collaborative environment.

In Short

• Work in Utilization Management, a 24/7 operation.
• Assess and coordinate healthcare services for members.
• Gather clinical information to make coverage determinations.
• Communicate with providers to facilitate care.
• Identify referral opportunities for integrated services.
• Consult with internal and external parties on benefit management.
• Maintain productivity and quality standards in a typical office environment.
• Proficiency in computer skills and multitasking is required.
• Must have effective verbal and written communication skills.
• Work schedules include weekends, holidays, and evenings.

Requirements

• 2+ years as a Registered Nurse in adult acute care/critical care.
• Active RN licensure in state of residence.
• 2+ years of clinical experience in med surg or specialty area preferred.
• Managed Care experience, especially in Utilization Management, is preferred.
• Associates Degree required; BSN preferred.

Benefits

• Competitive wages and comprehensive benefits package.
• 401(k) plan with company matching contributions.
• No-cost wellness programs and counseling services.
• Flexible work schedules and paid time off.
• Tuition assistance and dependent care resources.