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UM Nurse Consultant (remote) - Remote Eligible

Facilitate appropriate healthcare services and coverage determinations for members through clinical assessments.
Remote
Mid-Level
$26.01-$56.14 USD per hour
2 weeks ago
CVS Health

CVS Health

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

✨ 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 over three years of experience as a Registered Nurse, demonstrating a strong clinical background. - Candidates should possess an active and unrestricted RN licensure in their state of residence. - Experience in acute or post-acute settings is essential, with at least one 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.
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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.