Utilization Management Nurse Consultant – Weekend Shift

Job not on LinkedIn

🔥 3 hours ago

🐎 Kentucky – Remote

🐎 Kentucky – Remote

💵 $26 - $56 / hour

⏰ Full Time

🟡 Mid-level

🟠 Senior

💼 Consultant

👻 Ghost score 0%

What it means: how likely this posting is sitting open without active hiring.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

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 1963

🏥 Healthcare

⚕️ Healthcare Insurance

🛒 Retail

Healthcare • Healthcare Insurance • Retail

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

• 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 quality and effective healthcare services and benefit utilization • Consult with and provide expertise to internal and external constituents in utilization and benefit management • Work two 10-hour weekend shifts and two 10-hour weekday shifts • Meet standard productivity and quality expectations • Perform close inspection of handwritten and computer-generated documents • Sit for extended periods, talk on the telephone, type, multitask and prioritize in a fast-paced environment

🎯 Requirements

• Ability to work a weekend position: Saturday/Sunday plus two weekdays • Active, current and unrestricted RN licensure in Kentucky or multi-state compact RN licensure • 3+ years of clinical experience • Proficiency with computer skills, including navigating multiple systems and keyboarding • Ability to work in a fast-paced environment • Effective verbal and written communication skills • Associate degree required • Previous prior authorization experience preferred • BSN preferred

🏖️ 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