Utilization Management Nurse Consultant

CVS Health
Washington, District of Columbia, United States
Full Time
Remote
Mid
USD 66,581 – 142,584
Associate Degree
Healthcare Healthcare Life Sciences

Posted 1 week ago

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Excellent 4.7

Job summary

The Utilization Management Nurse Consultant assesses, plans, and coordinates healthcare services for members, communicating with providers and promoting quality healthcare utilization in a fast-paced environment.

Responsibilities

Assess members’ clinical information and apply clinical criteria, policies, and judgment to make or recommend coverage determinations across the continuum of care. Coordinate with providers and other parties, identify referrals and opportunities to improve care quality and benefit utilization, and support the administration of utilization management.

Qualifications

clinical assessment clinical judgment communication computer skills critical care healthcare services med surg utilization management

Requires an active, unrestricted RN license and at least two years of adult acute-care or critical-care nursing experience; an associate degree is required, and a BSN is preferred. Med-surg or specialty clinical experience is preferred, as is managed-care or utilization-management experience, along with the ability to work evenings, weekends, and holidays in a 24/7 operation.

English

Benefits

  • Medical Insurance
  • Dental Insurance
  • Vision Insurance
  • Paid Time Off
  • Retirement Savings Options
  • Wellness Programs

Company

CVS Health

CVS Health

linkedin
Hospitals and Health Care
Location
Washington, District of Columbia, United States

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Excellent 4.7
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