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Clinical Nurse Consultant
1 month ago
CVS Health is seeking a skilled Clinical Nurse Consultant to join our team. As a key member of our Utilization Management team, 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.
You will gather clinical information and apply clinical criteria, guidelines, policies, procedures, and judgment to render coverage determinations and recommendations along the continuum of care. Effective communication with providers and other parties will be essential in facilitating care and treatment.
Key Responsibilities:
- Assess, plan, implement, coordinate, monitor, and evaluate options to facilitate appropriate healthcare services and benefits for members
- Gather clinical information and apply clinical criteria, guidelines, policies, procedures, and judgment to render coverage determinations and recommendations
- Communicate with providers and other parties to facilitate care and treatment
- Identify opportunities to promote quality effectiveness of healthcare services and benefit utilization
- Consult and lend expertise to other internal and external constituents in the coordination and administration of the utilization/benefit management function
Requirements:
- 3+ years of experience as a Registered Nurse
- Active current and unrestricted RN licensure in state of residence
- 1+ years of clinical experience in acute or post-acute setting
- Ability to obtain additional nursing licenses as business needs require
CVS Health offers a competitive salary range of $26.01 - $56.13, with opportunities for bonus, commission, or short-term incentive programs. Our comprehensive benefits package includes medical, dental, and vision benefits, 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.
