Utilization Management Nurse Consultant

Job not on LinkedIn

🔥 14 hours ago

🌪️ Kansas – Remote

🌪️ Kansas – Remote

💵 $26 - $56 / hour

⏰ Full Time

🟢 Junior

🟡 Mid-level

💼 Consultant

👻 Ghost score 0%

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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 across the continuum of care • 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, effectiveness and benefit utilization • Consult with and provide expertise to internal and external constituents regarding utilization and benefit management • Work in a typical office environment while meeting productivity and quality expectations

🎯 Requirements

• 2+ years of experience as a Registered Nurse in adult acute care/critical care setting • Active, current and unrestricted RN licensure in state of residence • Associates Degree required • Clinical experience in med surg or specialty area • Ability to work weekends, holidays, and evening hours in a 24/7 operation • Proficiency with computer skills, including navigating multiple systems and keyboarding • Effective verbal and written communication skills • Ability to multitask, prioritize and effectively adapt to a fast-paced changing environment • Ability to perform close inspection of handwritten and computer-generated documents and a PC monitor • Ability to sit for extended periods, talk on the telephone, and type on the computer

🏖️ Benefits

• Medical coverage • Dental coverage • Vision coverage • Paid time off • Retirement savings options • Wellness programs • Other resources supporting physical, emotional, and financial well-being • CVS Health bonus, commission or short-term incentive program in addition to base pay

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