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Remote UM Nurse Consultant, MI - Remote Eligible

Review and apply evidenced-based clinical criteria to authorize procedures/services for enhanced healthcare delivery.
Remote
Mid-Level
$29.10-$62.31 USD per hour
2 weeks ago
CVS Health

CVS Health

Enabling a more transparent, simple health care system

Job is no longer active
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✨ About The Role

- The primary responsibility of this role is to apply critical thinking and clinical guidelines to make decisions on services requiring precertification. - The majority of the work involves collecting and reviewing clinical information from providers over the phone and at a desk. - The position requires the use of specific criteria to authorize procedures/services or initiate a Medical Director referral when necessary. - The role involves sedentary work, including sitting, talking, listening, and computer use. - The candidate will be part of a team focused on transforming culture, accelerating innovation, and delivering personalized, convenient, and affordable healthcare solutions.
- The successful candidate should have at least 3 years of clinical experience and an active, unrestricted RN licensure in their state of residence. - Proficiency with computer skills and the ability to navigate multiple systems is crucial for this role. - The ideal candidate must be comfortable working in a fast-paced environment and be willing to work Monday to Friday with rotating weekend/holiday on-call shifts. - Strong critical thinking skills and the ability to apply evidenced-based clinical criteria are essential for making decisions related to precertification. - The candidate should be detail-oriented, empathetic, and able to communicate effectively with healthcare providers.
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Remote UM Nurse Consultant, MI - Remote Eligible
Remote
$29.10-$62.31 USD per hour
Remote
Job is no longer active
About CVS Health
Enabling a more transparent, simple health care system