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Remote UM Nurse Consultant, PA
Implement strategies to integrate referral opportunities with other products and services.
Various
Senior
$30.39-$65.66 USD per hour
4 months ago
✨ About The Role
- The role involves utilizing clinical experience to assess, plan, implement, coordinate, monitor, and evaluate options to facilitate appropriate healthcare services for members
- Requires gathering clinical information and applying appropriate clinical criteria/guidelines to render coverage determinations/recommendations
- Involves communicating with providers and other parties to facilitate care/treatment
- Identifying members for referral opportunities to integrate with other products, services, and programs
- Consulting and lending expertise to internal and external constituents in the coordination and administration of the utilization/benefit management function
âš¡ Requirements
- Experienced Registered Nurse with a minimum of 3 years of clinical experience in an acute or post-acute setting
- Must have an active and unrestricted RN licensure in the state of residence
- Ability to work Monday through Friday from 8 AM to 5 PM in the time zone of residence
- Proficient in computer skills, including navigating multiple systems and keyboarding
- Effective communication skills, both verbal and written
About CVS Health
Enabling a more transparent, simple health care system