CVS Health
10,000+ employees
Founded 1963
🏥 Healthcare
⚕️ Healthcare Insurance
🛒 Retail
Healthcare • Healthcare Insurance • Retail
CVS Health is a leading American healthcare company dedicated to improving health access and affordability. The company focuses on a comprehensive approach that includes health services, health insurance, and pharmacy benefits management. Through its subsidiaries, such as Aetna and CVS Caremark, CVS Health offers a range of services that facilitate wellness, condition management, and affordable prescription drug coverage. CVS Health operates neighborhood pharmacies, provides mail-order pharmacy services, and manages specialty medication programs, aiming to make healthcare convenient and accessible for everyone. Driven by a mission to connect people with essential care services, CVS Health is committed to fostering healthier communities and supporting the wellbeing of all individuals.
Utilization Management Nurse Consultant
Job not on LinkedIn
🕒 2 days ago
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CVS Health
10,000+ employees
Founded 1963
🏥 Healthcare
⚕️ Healthcare Insurance
🛒 Retail
Healthcare • Healthcare Insurance • Retail
CVS Health is a leading American healthcare company dedicated to improving health access and affordability. The company focuses on a comprehensive approach that includes health services, health insurance, and pharmacy benefits management. Through its subsidiaries, such as Aetna and CVS Caremark, CVS Health offers a range of services that facilitate wellness, condition management, and affordable prescription drug coverage. CVS Health operates neighborhood pharmacies, provides mail-order pharmacy services, and manages specialty medication programs, aiming to make healthcare convenient and accessible for everyone. Driven by a mission to connect people with essential care services, CVS Health is committed to fostering healthier communities and supporting the wellbeing of all individuals.
📋 Description
• Review clinical records to determine medical necessity and appropriate benefit utilization • Coordinate and communicate utilization management activities with providers and facilities • Support safe, timely, and effective discharge planning • Ensure compliance with federal and state turnaround-time requirements • Collaborate with interdisciplinary teams to meet complex member needs
🎯 Requirements
• Active, unrestricted RN license in the state of residence • 2+ years of recent acute care hospital RN experience (within the past 10 years) • Utilization Review experience (preferred) • Managed Care experience (preferred) • Strong telephonic communication skills (preferred) • BSN (preferred) • Proficiency with Microsoft Office (Word, Excel, PowerPoint, Outlook) (preferred)
🏖️ Benefits
• Medical, dental, and vision coverage • Paid time off • Retirement savings options • Wellness programs
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