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Nurse Consultant

2 months ago

Jefferson City, Missouri, United States CVS Health Full time
About the Role

CVS Health is seeking a skilled Nurse Consultant to join our Utilization Management team. As a key member of our team, you will play a critical role in ensuring that our members receive the most appropriate and effective healthcare services.

Key Responsibilities
  • Collaborate with healthcare providers and other stakeholders to assess, plan, implement, coordinate, monitor, and evaluate options for healthcare services and benefits for our members.
  • Utilize clinical expertise and judgment to render coverage determinations and recommendations along the continuum of care.
  • Communicate effectively with providers and other parties to facilitate care and treatment, and identify opportunities to promote quality and effectiveness of healthcare services and benefit utilization.
  • Consult and lend expertise to internal and external constituents in the coordination and administration of the utilization/benefit management function.
Requirements
  • Active current and unrestricted RN licensure in the state of residence.
  • At least 3 years of experience as a Registered Nurse.
  • 1+ years of clinical experience in an acute or post-acute setting.
  • 2+ years of experience working with MS Office applications, including Teams, Outlook, Excel, and Word.
  • Ability to work Monday - Friday, 8:00am-5pm CST, with some weekends and holidays required.
Preferred Qualifications
  • Experience working in ER, Med/Surg, and/or Critical Care settings.
  • Managed Care experience.
  • Utilization review experience.
  • Experience working with Electronic Medical Record systems, such as EPIC, Cerner, or Meditech.
What We Offer

CVS Health offers a comprehensive benefits package, including 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.