Nurse Consultant

4 weeks ago


Albany, New York, United States CVS Health Full time
About the Role

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.
Requirements
  • 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.
Preferred Qualifications
  • Managed Care experience.
  • Education: Associate's Degree required, BSN preferred.
What We Offer

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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