Utilization Management Nurse Consultant - NICU/Spine (Remote)

Overview

The Utilization Management Nurse Consultant for NICU/Spine at CVS Health plays a vital role in managing healthcare services that require precertification, ensuring patients receive the appropriate care with a focus on clinical criteria and guidelines.

In Short

• Remote position with a schedule from 8:00 AM to 5:00 PM CST.
• Engage in critical thinking and clinical practice for precertification services.
• Review clinical information from providers primarily via phone.
• Authorize inpatient NICU/Spine admissions based on specific criteria.
• Must hold active RN licensure in the state of residence.
• 3+ years of clinical experience required.
• Proficiency with computer systems essential.
• Occasional weekend/holiday on-call may be required.
• Associates degree required; BSN preferred.
• Eligible for bonuses and comprehensive benefits.

Requirements

• Active RN licensure in state of residence.
• 3+ years of clinical experience.
• Willingness to work Monday - Friday 8 AM - 5 PM CST.
• Proficiency in navigating multiple computer systems.
• Experience in NICU and Utilization Management preferred.
• Associates degree required; BSN preferred.

Benefits

• Affordable medical plan options.
• 401(k) plan with matching contributions.
• No-cost wellness programs.
• Flexible work schedules and paid time off.
• Tuition assistance and financial coaching.