Utilization Management Nurse Consultant

Job not on LinkedIn

🔥 16 hours ago

🏈 Ohio – Remote

🏈 Ohio – Remote

💵 $29 - $62 / 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.Why this score:

• Open for 1 day.
• Jobs at this company usually fill in 21 days.

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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 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, effectiveness, and benefit utilization • Consult with and provide expertise to internal and external constituents in coordinating and administering utilization and benefit management • Work in a typical office environment with productivity and quality expectations • Perform sedentary work involving extended sitting, telephone conversations, listening, and computer typing

🎯 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 • Ability to work weekends, holidays, and evening hours in a 24/7 operation • Comfortable setting up and using multiple monitors and navigating multiple applications simultaneously • Ability to communicate via email, calendar invites, Teams messaging, and virtual meetings • Experience with Microsoft Office 365 (Teams, Outlook, Word, Excel, PowerPoint) or similar Google Workspace applications • Ability to log in to secure systems such as VPN and EHR portals, secure computer systems, manage strong passwords, and recognize suspicious emails or links • Ability to troubleshoot common technical issues independently • Direct/hardwired internet connection to modem/router within 7 feet of computer • Minimum internet speed of 50 Mbps download and 5 Mbps upload • Quiet, secure, private designated home workspace compliant with CVS Health and HIPAA guidelines • Must work within the state and city where currently residing • Associates Degree required • Ability to obtain and adhere to required work-from-home internet and workspace requirements • Ability to perform close inspection of handwritten and computer-generated documents and PC monitor • Computer proficiency, keyboarding, multitasking, prioritization, and effective adaptation to a fast-paced changing environment • Effective verbal and written communication skills

🏖️ 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 eligibility • Company-provided equipment (keyboard, monitor, computer, headset, etc.)

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