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CVS Health logo
CVS Health

Bringing our heart to every moment of your health.

Appeals Nurse Consultant

ConsultantConsultantFull TimeRemoteSeniorTeam 10,001+Since 1963H1B No SponsorCompany SiteLinkedIn

Location

Connecticut

Posted

19 days ago

Salary

$60.5K - $129.6K / year

Seniority

Senior

Associate Degree3 yrs expEnglish

Job Description

Appeals Nurse Consultant

CVS Health

• Responsible for the review and resolution of clinical appeals • Reviews documentation and interprets data obtained from clinical records • Independently coordinates the clinical resolution with internal/external clinician support as required • Support UM, MPO, Coding, or Behavioral Health appeals.

Job Requirements

  • Must have active and unrestricted RN licensure in state of residence
  • 3+ years clinical experience
  • Appeals, Managed Care, or Utilization Review experience preferred
  • Proficiency with computer skills including navigating multiple systems
  • Exceptional communication skills
  • Time efficient, highly organized, and ability to multitask
  • Associate's Degree minimum.

Benefits

  • Medical, dental, and vision coverage
  • Paid time off
  • Retirement savings options
  • Wellness programs

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