Utilization Management Nurse Consultant

CVS Health
Arizona, United States
Full Time
Remote
Senior
USD 60,528 – 129,626
Associate Degree
Healthcare Healthcare Life Sciences

Posted 5 days ago

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Excellent 4.7

Job summary

Assist in healthcare service authorization and coordination as a Utilization Management Nurse, utilizing clinical judgment to evaluate, recommend, and communicate about healthcare coverage for members, primarily in a Medicare context.

Responsibilities

The Utilization Management Nurse Consultant assesses, plans, and coordinates healthcare services for members by applying clinical criteria and guidelines. They also communicate with providers to facilitate treatment and identify opportunities to improve the quality and effectiveness of healthcare benefit utilization.

Qualifications

Ambulatory surgery Managed care Med/Surg MedCompass Microsoft Office Registered Nurse Utilization Management

Candidates must have at least 3 years of experience as a Registered Nurse with an active, unrestricted license and 1 year of Med/Surg experience. Proficiency in Microsoft Office applications is required, and prior experience in Utilization Management or Prior Authorization is preferred.

English

Benefits

  • Medical coverage
  • Dental coverage
  • Vision coverage
  • Paid time off
  • Retirement savings options
  • Wellness programs

Company

CVS Health

CVS Health

linkedin
Hospitals and Health Care
Location
Arizona, United States

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Excellent 4.7
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