Utilization Management Nurse Consultant

Job not on LinkedIn

🔥 0 minutes ago

🏈 Alabama – Remote

🏈 Alabama – Remote

💵 $26 - $56 / hour

⏰ Full Time

🟢 Junior

🟡 Mid-level

💼 Consultant

👻 Ghost score 0%

What it means: the chance that no one is really hiring for this job.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

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CVS Health Careers

WebsiteLinkedInAll Job Openings

10,000+ employees

🏥 Healthcare

🛒 Retail

📦 Logistics

Healthcare • Retail • Logistics

CVS Health Careers is the recruitment and employer branding arm of CVS Health, showcasing job opportunities across the company's broad operations—pharmacy retail stores, pharmacy services, health care clinics, distribution warehouses, corporate functions and transportation. The careers site emphasizes purpose-driven work focused on improving access, affordability and quality of health care, and highlights a large workforce (300,000+ employees), inclusive culture, benefits, and hiring resources for applicants.

📋 Description

• Assess, plan, implement, coordinate, monitor and evaluate options to facilitate appropriate healthcare services and benefits for members • Gather clinical information and apply clinical criteria, guidelines, policies, procedures and clinical judgment to render coverage determinations or recommendations • Communicate with providers and other parties to facilitate care and treatment • Identify members for referral opportunities involving other products, services and programs • Identify opportunities to promote healthcare service quality and effective benefit utilization • Consult with and provide expertise to internal and external constituents in utilization and benefit management • Work in a typical office environment with productivity and quality expectations • Perform close inspection of handwritten and computer-generated documents and PC monitors • Sit for extended periods, talk on the telephone and type on a computer • Multitask, prioritize and adapt effectively to a fast-paced changing environment

🎯 Requirements

• 2+ years of clinical experience as a Registered Nurse in a hospital setting in adult acute care/critical care setting • Active, current and unrestricted RN licensure in state of residence • Ability to work weekends, holidays and evening hours as part of a 24/7 operation • Associate or Bachelor of Science in Nursing (BSN preferred) • Direct/hardwired internet connection to a modem/router within 7 feet of computer • Minimum internet speed of 25 Mbps download and 3 Mbps upload • Quiet, secure and private designated home virtual work location compliant with CVS Health and HIPAA guidelines • Must work within the state and city where currently residing • Ability to use multiple monitors and navigate multiple applications simultaneously • Ability to communicate via email, calendar invites, Teams messaging and virtual meetings • Experience with Microsoft Office 365 applications or similar Google Workspace tools • Ability to access secure systems such as VPN and EHR portals • Ability to follow computer security practices, manage strong passwords and recognize suspicious emails or links • Ability to troubleshoot common technical issues independently • Proficiency with computer skills, navigating multiple systems and keyboarding • Effective verbal and written communication skills

🏖️ Benefits

• CVS Health bonus, commission or short-term incentive program in addition to base pay • Medical coverage • Dental coverage • Vision coverage • Paid time off • Retirement savings options • Wellness programs • Other resources supporting physical, emotional, and financial well-being • Company-provided equipment (keyboard, monitor, computer, headset, etc.)

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