Utilization Management Nurse Consultant - Prior Authorizations - Remote

Overview

The Utilization Management Nurse Consultant role at CVS Health focuses on prior authorizations, utilizing critical thinking and clinical criteria to ensure member needs are met.

In Short

• Telework position for prior authorization
• Use clinical practice guidelines for precertification
• Advocate for members while assessing their needs
• Majority of work involves desk and phone activities
• Authorize procedures/services or refer to Medical Director
• Requires active RN licensure in state of residence
• Minimum of 3 years clinical experience required
• Proficiency in computer skills is necessary
• Work schedule is Monday - Friday, 8 am - 5 pm
• Competitive pay and benefits offered

Requirements

• Active, unrestricted RN licensure
• 3+ years of clinical experience
• Ability to work in a fast-paced environment
• Preferred prior authorization experience
• Associates degree required, BSN preferred
• Willingness to work occasional weekends/holidays

Benefits

• Affordable medical plan options
• 401(k) plan with company matching
• Employee stock purchase plan
• No-cost wellness programs
• Flexible work schedules
• Tuition assistance
• Comprehensive benefits for employees and families