Clinical Nurse Consultant

2 weeks ago


Trenton, New Jersey, United States CVS Health Full time
Job Summary

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 for member care, ensuring alignment with clinical guidelines and policies.
  • Collaborate with healthcare providers and other stakeholders to facilitate care and treatment, promoting quality and effectiveness of healthcare services.
  • Identify opportunities to promote quality and effectiveness of healthcare services and benefit utilization, driving positive outcomes for our members.
  • Consult and lend expertise to internal and external constituents on utilization and benefit management, ensuring seamless coordination and administration.
Requirements
  • 3+ years of experience as a Registered Nurse, with a strong background in acute or post-acute care.
  • Active, current, and unrestricted RN licensure in the state of residence.
  • Proficiency in computer skills, including navigating multiple systems and keyboarding.
  • Effective communication and interpersonal skills, with the ability to work in a fast-paced environment.
Preferred Qualifications
  • Managed Care experience, with a strong understanding of healthcare utilization and management.
  • Strong preference for a med-surg background, with experience in clinical resource management.
What We Offer

CVS Health is committed to providing a comprehensive benefits package, including medical, dental, and vision coverage, as well as a 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. Our employees enjoy paid time off, paid holidays, and a CVS store discount.



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