Utilization Management Nurse Consultant

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🔥 19 hours ago

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Logo of CVS Health

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 information and apply guidelines to support coverage decisions • Collaborate with providers and care teams to coordinate appropriate treatment • Identify opportunities to improve care quality and resource utilization • Connect members to programs and services that support better outcomes • Provide clinical expertise across internal and external teams

🎯 Requirements

• Active, unrestricted RN license in your state of residence • 2+ years of adult acute care or critical care experience • Strong clinical judgment, communication, and organizational skills • Ability to multitask and thrive in a fast-paced, technology-driven environment • Preferred Experience in Med-Surg or a specialty area • Managed Care or Utilization Management experience

🏖️ Benefits

• medical, dental, and vision coverage • paid time off • retirement savings options • wellness programs • other resources

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