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Clinical Nurse Consultant
2 months ago
Company Overview
At CVS Health, we are committed to enhancing health care by putting our heart into every interaction. Our mission is to provide human-centric health services that adapt to the evolving needs of our communities.
Position Summary
The role of the Nurse Consultant involves leveraging clinical expertise to assess, plan, implement, and evaluate healthcare services for our members. This position is pivotal in ensuring that members receive appropriate healthcare benefits and services.
Key Responsibilities
- Utilize clinical knowledge to conduct comprehensive assessments and develop tailored care plans.
- Gather and analyze clinical data to apply relevant guidelines and policies for coverage determinations.
- Collaborate with healthcare providers and stakeholders to facilitate effective treatment and care coordination.
- Identify opportunities for improving the quality and efficiency of healthcare services and benefit utilization.
- Provide expert consultation to internal and external partners regarding utilization management processes.
Work Environment
This position is primarily office-based, requiring the ability to focus on detailed documents and utilize computer systems effectively. The role demands strong communication skills, both verbal and written, and the ability to multitask in a dynamic environment.
Qualifications
- A minimum of 3 years of experience as a Registered Nurse.
- Active and unrestricted RN licensure in the state of residence.
- At least 1 year of clinical experience in acute or post-acute care settings.
- Availability to work in a 24/7 operation, including potential weekends and holidays.
Preferred Qualifications
- Experience in managed care and discharge planning.
- Background in utilization management.
Education
- An Associate's Degree or Nursing Diploma is required; a BSN is preferred.
Compensation and Benefits
The typical pay range for this role is competitive and commensurate with experience. CVS Health offers a comprehensive benefits package, including medical, dental, and vision coverage, a 401(k) retirement savings plan, and various well-being programs. Employees enjoy paid time off and holiday benefits, fostering a supportive work-life balance.
Equal Opportunity Employer
CVS Health is an equal opportunity and affirmative action employer. We do not discriminate based on any protected characteristic.