Nurse Consultant
4 weeks ago
CVS Health is seeking a skilled Nurse Consultant to join our team. As a key member of our Utilization Management team, you will play a critical role in ensuring that our members receive the highest quality care.
Key Responsibilities- Utilize clinical expertise to assess, plan, implement, coordinate, monitor, and evaluate options to facilitate appropriate healthcare services and benefits for members.
- Gather clinical information and apply relevant clinical criteria, guidelines, policies, procedures, and judgment to render coverage determinations and recommendations.
- Communicate with providers and other parties to facilitate care and treatment, and identify opportunities to promote quality effectiveness of healthcare services and benefit utilization.
- Consult and lend expertise to internal and external constituents in the coordination and administration of the utilization/benefit management function.
- 3+ years of experience as a Registered Nurse.
- 3+ years of clinical experience required.
- Active current and unrestricted RN licensure in the state of residence.
- 1+ year(s) of clinical experience in an acute or post-acute setting.
- Managed Care experience.
- Education: Associate's Degree required, BSN preferred.
CVS Health offers a comprehensive benefits package, including medical, dental, and vision benefits, a 401(k) retirement savings plan, and an Employee Stock Purchase Plan. We also offer numerous well-being programs, education assistance, and a CVS store discount.
As a CVS Health employee, you will have access to a range of benefits and programs designed to support your physical, emotional, and financial well-being. We are committed to creating a work environment that is inclusive, diverse, and supportive of all employees.
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