Clinical Nurse Consultant
1 week ago
CVS Health is seeking a skilled Clinical Nurse Consultant to join our team. As a key member of our Utilization Management department, you will play a critical role in assessing, planning, implementing, coordinating, monitoring, and evaluating options to facilitate appropriate healthcare services and benefits for our members.
Key Responsibilities- Utilize clinical expertise to assess and plan healthcare services and benefits for members
- Apply clinical criteria, guidelines, policies, and procedures to render coverage determinations and recommendations
- Communicate with healthcare providers and other stakeholders to facilitate care and treatment
- Identify opportunities to promote quality and effectiveness of healthcare services and benefit utilization
- Consult and lend expertise to internal and external constituents on utilization and benefit management
- Active, current, and unrestricted RN licensure in the state of residence
- 3+ years of experience as a Registered Nurse
- 1+ years of clinical experience in an acute or post-acute setting
- Ability to work in a 24/7 operation with a minimum of 6 weekend rotations per year
- Residing in PST or CST time zones
- Utilization review experience
- Managed Care experience
CVS Health offers a competitive salary range of $26.01 - $56.14, as well as a comprehensive benefits package, including medical, dental, and vision coverage, 401(k) retirement savings plan, and employee stock purchase plan. We also offer a fully-paid term life insurance plan, short-term and long-term disability benefits, and numerous well-being programs.
Join our team and contribute to delivering enhanced human-centric healthcare services to our members. Apply today to become a part of our dynamic and innovative team at CVS Health
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