Overview
The Utilization Management Nurse Consultant at CVS Health plays a crucial role in coordinating and managing healthcare services for members, utilizing clinical skills and judgment to ensure appropriate care delivery.
In Short
• Utilize clinical skills for utilization/benefit management.
• Coordinate and document healthcare services for members.
• Communicate with providers to facilitate care.
• Identify referral opportunities for integrated services.
• Consult with internal and external parties on management functions.
• Work in a typical office environment with productivity expectations.
• Must be able to work weekends, holidays, and evenings.
• Proficiency in computer skills is required.
• Effective verbal and written communication skills are essential.
• 3+ years of experience as a Registered Nurse is required.
Requirements
• Active RN licensure in state of residence.
• 1+ years of clinical experience in acute or post-acute settings.
• Availability for a minimum of 6 weekend rotations per year.
• Willingness to work Monday through Friday in specified time zones.
• 3+ years of clinical experience preferred.
• Managed Care experience is a plus.
• Associates Degree required; BSN preferred.
Benefits
• Full range of medical, dental, and vision benefits.
• 401(k) retirement savings plan available.
• Employee Stock Purchase Plan for eligible employees.
• Fully-paid term life insurance for eligible employees.
• Short-term and long-term disability benefits offered.
• Paid Time Off (PTO) and paid holidays provided.
• Numerous well-being programs and education assistance.
• Discount programs with participating partners.
• Free development courses available.
• CVS store discount for employees.