Clinical Nurse Consultant

4 weeks ago


Jefferson City, Missouri, 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 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 utilize your clinical experience and skills to gather information, apply clinical criteria, guidelines, policies, and procedures to render coverage determinations and recommendations. Your excellent communication skills will enable you to effectively collaborate with providers and other stakeholders to facilitate care and treatment.

This is a challenging and rewarding role that requires strong clinical expertise, excellent communication skills, and the ability to work in a fast-paced environment. If you are a motivated and detail-oriented nurse with a passion for delivering high-quality patient care, we encourage you to apply.

Key Responsibilities:

  • Assess, plan, implement, coordinate, monitor, and evaluate options to facilitate appropriate healthcare services and benefits for members
  • Utilize clinical experience and skills to gather information and apply clinical criteria, guidelines, policies, and procedures to render coverage determinations and recommendations
  • Communicate effectively with providers and other stakeholders 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

Preferred Qualifications:

  • 3+ years of clinical experience
  • 1+ years of managed care experience

What We Offer:

  • Competitive pay range: $56.13 per hour
  • Eligibility for bonus, commission, or short-term incentive program
  • Full range of medical, dental, and vision benefits
  • 401(k) retirement savings plan and employee stock purchase plan
  • Term life insurance and short-term and long-term disability benefits
  • Well-being programs, education assistance, and development courses
  • CVS store discount and discount programs with participating partners
  • Paid time off, paid holidays, and sick time


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