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UM Nurse Consultant (remote) - Remote Eligible
Facilitate appropriate healthcare services and coverage determinations for members through clinical assessment.
Remote
Mid-Level
$26.01-$56.14 USD per hour
1 week ago
CVS Health
CVS Health is a leading pharmacy and healthcare company offering prescriptions, products, and wellness services.
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✨ About The Role
- This position involves utilizing clinical experience to assess, plan, implement, coordinate, monitor, and evaluate healthcare services for members.
- The role requires gathering clinical information and applying appropriate clinical criteria to make coverage determinations.
- Communication with providers and other parties is essential to facilitate care and treatment for members.
- The job includes identifying members for referral opportunities to integrate with other products and services.
- The position operates within a 24/7 utilization management framework, requiring flexibility for weekend, holiday, and evening rotations.
âš¡ Requirements
- The ideal candidate will have at least 3 years of experience as a Registered Nurse, demonstrating a strong clinical background.
- Candidates should possess active and unrestricted RN licensure in their state of residence.
- Experience in acute or post-acute settings is essential, with a minimum of 1 year of clinical experience required.
- Strong communication skills, both verbal and written, are necessary for effective collaboration with providers and other parties.
- The ability to multitask and adapt to a fast-paced, changing environment is crucial for success in this role.
UM Nurse Consultant (remote) - Remote Eligible
Remote
$26.01-$56.14 USD per hour
Remote
About CVS Health
CVS Health is a leading pharmacy and healthcare company offering prescriptions, products, and wellness services.