CVS Health

Bringing our heart to every moment of your health.

Nurse Consultant

ConsultantConsultantFull TimeRemoteMid LevelTeam 10,001+Since 1963H1B No SponsorCompany SiteLinkedIn

Location

New Jersey

Posted

7 days ago

Salary

$32 - $68 / hour

Seniority

Mid Level

Associate Degree2 yrs expEnglish

Job Description

• Utilizes clinical experience and skills in a collaborative process to assess, plan, implement, coordinate, monitor and evaluate options to facilitate appropriate healthcare services/benefits for members • Gathers clinical information and applies the appropriate clinical criteria/guideline, policy, procedure and clinical judgment to render coverage determination/recommendation along the continuum of care • Communicates with providers and other parties to facilitate care/treatment • Identifies members for referral opportunities to integrate with other products, services and/or programs • Identifies opportunities to promote quality effectiveness of Healthcare Services and benefit utilization • Consults and lends expertise to other internal and external constituents in the coordination and administration of the utilization/benefit management function

Job Requirements

  • 2+ years of experience as a Registered Nurse in adult acute care/critical care setting
  • Must have active current and unrestricted RN licensure in state of residence
  • Utilization Management is a 24/7 operation and work schedules will include weekends, holidays, and evening hours
  • 2+ years of clinical experience required in med surg or specialty area
  • Managed Care experience preferred, especially Utilization Management
  • Preference for those residing in Eastern time zone
  • Associates Degree required, BSN 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

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