Appeals Nurse Consultant (remote)

✨ About The Role

- The Appeals Nurse Consultant will be responsible for reviewing and resolving clinical appeals.
	- This role involves interpreting data from clinical records to apply appropriate clinical criteria and policies.
	- The position requires independent coordination of clinical resolutions with internal and external clinician support.
	- The consultant may support various types of appeals, including UM, MPO, Coding, or Behavioral Health appeals.
	- The work schedule is Monday to Friday from 8 AM to 5 PM in the time zone of residence.
                            

⚡ Requirements

- The ideal candidate will have an active and unrestricted RN licensure in their state of residence.
	- A minimum of 3 years of clinical experience is required for this role.
	- Experience in appeals, managed care, and utilization review is preferred.
	- Strong computer skills are essential, including the ability to navigate multiple systems efficiently.
	- Exceptional communication skills are necessary to coordinate clinical resolutions effectively.
	- The candidate should be time-efficient, highly organized, and capable of multitasking in a fast-paced environment.
                            

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Appeals Nurse Consultant (remote) - Remote Eligible

Remote

$66,575 - 142,576 USD / year

Remote

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About CVS Health

CVS Health is a leading pharmacy and healthcare company offering prescriptions, products, and wellness services.