Utilization Management Nurse Consultant

Job not on LinkedIn

🔥 30 minutes ago

🏄 California – Remote

🏄 California – Remote

💵 $32 - $68 / hour

⏰ Full Time

🟢 Junior

🟡 Mid-level

💼 Consultant

Apply Now

Find Similar Remote Jobs

Set Up Email Alert For New Jobs

📊 Check your resume score for this job

Improve your chances of getting an interview by checking your resume score before you apply.

Upload Resume

CVS Health

WebsiteLinkedInAll Job Openings

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 information and apply evidence-based criteria, policies, and clinical judgment to support coverage determinations • Assess, coordinate, monitor, and evaluate healthcare services and benefits for members • Collaborate with providers and care teams to facilitate appropriate treatment and care planning • Identify opportunities to improve healthcare quality, effectiveness, and utilization • Connect members with additional programs and services that support their overall health needs • Serve as a clinical resource for internal and external stakeholders

🎯 Requirements

• Active, unrestricted RN license in your state of residence • 2+ years of adult acute care and/or critical care nursing experience • Strong clinical assessment, critical thinking, and communication skills • Ability to navigate multiple systems and work efficiently in a fast-paced environment • Associate Degree in Nursing required

🏖️ Benefits

• medical, dental, and vision coverage • paid time off • retirement savings options • wellness programs • comprehensive benefits package