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Remote Utilization Management Nurse Consultant- Oncology and Transplant - Remote Eligible

Collaborate with providers to ensure appropriate utilization of Oncology and Transplant services.
Remote
Senior
$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 working remotely from anywhere in the U.S. with set work hours from 11:30am-8:00pm EST, Monday-Friday - Responsibilities include working with providers to secure information for medical necessity reviews for Oncology and Transplant related services - Utilization Management nurses will need to apply critical thinking and clinical criteria to authorize procedures/services or initiate Medical Director referrals as needed - The position requires proficiency in computer skills, navigating multiple systems, and collecting & reviewing clinical information from providers - The job also involves attending the first 3 weeks of training with 100% participation during 8:30am-5pm EST, Monday-Friday

⚡ Requirements

- Experienced Registered Nurse with at least 3 years of acute clinical Oncology or Oncology/Transplant experience - Proficient in utilizing clinical criteria and practice guidelines for treatment and services, specifically inpatient and outpatient services requiring precertification - Ability to work in a high volume clinical call center environment and handle occasional on-call rotational coverage on weekends and holidays - Skilled in critical thinking and applying evidenced-based clinical criteria for medical necessity reviews - Holds an unrestricted RN license in their state of residence and willing to obtain multi-state/compact privileges
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Remote Utilization Management Nurse Consultant- Oncology and Transplant - Remote Eligible
Remote
$29.10-$62.31 USD per hour
Remote
About CVS Health
Enabling a more transparent, simple health care system