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Remote Prior Authorization Utilization Management Nurse Consultant, VA

Utilize clinical expertise to ensure appropriate authorization of health care services for patients.
Various
Mid-Level
$29.10-$62.31 USD per hour
1 week ago
CVS Health

CVS Health

Enabling a more transparent, simple health care system

✨ About The Role

- The role involves applying critical thinking and clinical guidelines for services requiring precertification. - Responsibilities include collecting and reviewing clinical information from providers over the phone. - The position requires authorizing procedures/services based on specific criteria or initiating a Medical Director referral as needed. - Must be able to work in a desk-based role, spending the majority of time on the phone and at a computer. - The job offers a pay range of $29.10 to $62.31 per hour, with additional benefits and incentives available.

⚡ Requirements

- Ideal for a registered nurse with at least 3 years of clinical experience, particularly in prior authorization. - Requires someone with an active, current, and unrestricted RN licensure in the state of Virginia or multi-state compact licensure. - Must be comfortable working Monday through Friday 8am to 5pm EST with occasional weekends. - Proficiency with computer skills and navigating multiple systems is essential for success in this role. - Ability to work in a fast-paced environment and apply critical thinking skills to clinical criteria and guidelines.
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Remote Prior Authorization Utilization Management Nurse Consultant, VA
Various
$29.10-$62.31 USD per hour
Remote
About CVS Health
Enabling a more transparent, simple health care system