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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
$32.01-$68.55 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
- The UM Nurse Consultant will utilize clinical experience to assess, plan, implement, coordinate, monitor, and evaluate healthcare services for members.
- This role involves gathering clinical information and applying appropriate clinical criteria to make coverage determinations.
- The consultant will communicate with providers to facilitate care and identify members for referral opportunities.
- The position requires occasional weekend, evening, and holiday rotations due to the 24/7 nature of utilization management.
- The job is primarily remote, with a typical work schedule of Monday to Friday from 8 AM to 5 PM EST.
âš¡ Requirements
- A successful candidate will have at least 3 years of experience as a Registered Nurse, demonstrating a strong clinical background.
- The individual should possess active and unrestricted RN licensure in their state of residence.
- Experience in acute or post-acute settings for at least one year is essential for this role.
- Strong communication skills, both verbal and written, are necessary to effectively interact with providers and other parties.
- The ability to multitask and prioritize in a fast-paced environment is crucial for managing the demands of utilization management.
UM Nurse Consultant (remote) - Remote Eligible
Remote
$32.01-$68.55 USD per hour
Remote
About CVS Health
CVS Health is a leading pharmacy and healthcare company offering prescriptions, products, and wellness services.