Utilization Management Nurse Consultant – Weekend

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🔥 3 hours ago

🐊 Florida, Idaho, +1 more states – Remote

🐊 Florida – Remote 🥔 Idaho – Remote 🤠 Texas – Remote

💵 $29 - $62 / hour

⏰ Full Time

🟡 Mid-level

🟠 Senior

💼 Consultant

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CVS Health

WebsiteLinkedInAll Job Openings

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

• Gather clinical information and apply appropriate clinical criteria, guidelines, policies, and procedures • Communicate with providers and other parties to facilitate care and treatment • Identify members for referral opportunities to integrate with other products, services, or benefit programs • Identify opportunities to promote quality and effectiveness of healthcare services and benefit utilization • Consult and lend expertise to internal and external constituents in coordination and administration of utilization management function • Meet productivity and quality expectations as established by UMNC

🎯 Requirements

• Registered Nurse • Diploma RN acceptable; Associate degree / BSN preferred • 3+ years of experience as a Registered Nurse • 1+ years of clinical experience in acute or post-acute setting • 1+ years of Utilization Management / Care Management Experience • Active current and unrestricted RN licensure in state of residence

🏖️ Benefits

• Medical, dental, and vision coverage • Paid time off • Retirement savings options • Wellness programs