CVS Health
10,000+ employees
Founded 1963
⚕️ Healthcare Insurance
🛒 Retail
🧘 Wellness
Healthcare Insurance • Retail • Wellness
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
🔥 3 hours ago
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CVS Health
10,000+ employees
Founded 1963
⚕️ Healthcare Insurance
🛒 Retail
🧘 Wellness
Healthcare Insurance • Retail • Wellness
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 documentation and apply criteria to support coverage determinations • Collaborate with providers and care teams to coordinate appropriate care • Identify opportunities to improve care quality and effective benefit utilization • Connect members to programs and services that enhance outcomes • Serve as a clinical resource to internal and external stakeholders
🎯 Requirements
• Active, unrestricted RN license in your state of residence • 2+ years of adult acute care or critical care experience • Strong clinical judgment and effective communication skills • Ability to multitask and work efficiently in a fast-paced, technology-driven environment • Experience in Med-Surg or a specialty area preferred • Managed Care or Utilization Management experience preferred • Associate’s Degree required, BSN preferred
🏖️ Benefits
• medical, dental, and vision coverage • paid time off • retirement savings options • wellness programs • other resources, based on eligibility
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