CVS Health is a leading healthcare company operating CVS Specialty, CVS Pharmacy, CVS MinuteClinic, and CVS Caremark. In 2018, CVS combined forces with healthca
Utilization Management Nurse Consultant
Location
Florida
Posted
4 days ago
Salary
$29 - $62 / hour
Seniority
Senior
Job Description
Utilization Management Nurse Consultant
CVS Health
• Utilize clinical experience and skills in a collaborative process to assess, plan, implement, coordinate, monitor, and evaluate options to facilitate appropriate healthcare services and benefits • Gather clinical information and apply appropriate clinical criteria to render coverage determinations and recommendations • Communicate with providers to facilitate care and treatment • Identify opportunities to promote quality and effectiveness of healthcare services • Consult with constituents in the coordination and administration of the utilization/benefit management function • Meet set productivity and quality expectations as established by UMNC
Job 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
- Utilization Management experience preferred
Benefits
- medical, dental, and vision coverage
- paid time off
- retirement savings options
- wellness programs
- other resources, based on eligibility
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