Utilization Management Expert

4 days ago


Austin, Texas, United States CVS Health Full time
About the Job
This Utilization Management Nurse Consultant position offers an exciting opportunity to make a meaningful impact on patient care and healthcare outcomes. As a key member of our team, you will be responsible for developing and implementing effective utilization management strategies to improve patient care and reduce costs. Your expertise in clinical decision-making, data analysis, and communication will be essential in driving high-quality outcomes and improving patient satisfaction.

Main Responsibilities
- Develop and implement effective utilization management strategies to optimize patient care and resource utilization
- Conduct thorough reviews of clinical information and documentation related to outpatient therapy services
- Collaborate with healthcare professionals and stakeholders to develop and implement effective care plans
- Analyze data and trends to identify opportunities for quality improvement and process optimization

Qualifications
- Bachelor's degree in Nursing or a related field
- 3+ years of experience in managed care, discharge planning, or utilization management
- Strong analytical and problem-solving skills
- Excellent communication and interpersonal skills

Benefits and Compensation
- Annual salary: $85,000 - $120,000
- Comprehensive benefits package, including medical, dental, and vision insurance
- Opportunities for professional growth and development

Work Environment
- Typical office working environment
- Must be willing and able to work Monday through Friday, 8:00am - 5:00pm CST
- May require occasional travel or overtime


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