Nurse Consultant
CVS Health
full-time
Posted on:
Location Type: Remote
Location: Tennessee • United States
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Salary
💰 $26 - $56 per hour
About the role
- Utilize your clinical experience and skills in a collaborative process to assess, plan, implement, coordinate, monitor, and evaluate options to facilitate appropriate healthcare services and benefits for members
- Gather clinical information and apply the appropriate clinical criteria, guidelines, policies, procedures, and clinical judgment to render coverage determinations and recommendations along the continuum of care
- Communicate with providers and other parties to facilitate care and treatment
- Identify members for referral opportunities to integrate with other products, services, or benefit programs
- Identify opportunities to promote quality and effectiveness of healthcare services and benefit utilization
- Consult and lend expertise to other internal and external constituents in the coordination and administration of the utilization/benefit management function
- Meet set productivity and quality expectations as established by UMNC
Requirements
- Registered Nurse
- Diploma RN acceptable; Associate degree/BSN preferred
- 3+ years of experience as a Registered Nurse
- 1+ years of clinical experience in acute or post-acute setting
- 1+ years of Utilization Management / Care Management Experience
- Must have active current and unrestricted RN licensure in state of residence
- May be required to obtain additional Nursing Licenses as business needs require
- Utilization Management experience preferred
Benefits
- Affordable medical plan options
- 401(k) plan (including matching company contributions)
- Employee stock purchase plan
- No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching
- Paid time off
- Flexible work schedules
- Family leave
- Dependent care resources
- Colleague assistance programs
- Tuition assistance
- Retiree medical access and many other benefits depending on eligibility
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills & Tools
clinical assessmentcare coordinationcoverage determinationsclinical judgmentutilization managementcare managementhealthcare services evaluationbenefit managementquality improvementproductivity standards
Soft Skills
collaborationcommunicationconsultationinterpersonal skillsorganizational skillsproblem-solvingcritical thinkingdecision-makingadaptabilityattention to detail
Certifications
Registered Nurse licensureAssociate degreeBachelor of Science in Nursing (BSN)