Utilization Management Nurse Consultant

CVS Health
Washington, District of Columbia, United States
Full Time
Remote
Mid
USD 54,101 – 142,584
Associate Degree
Healthcare Healthcare Life Sciences

Posted 5 days ago

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Excellent 4.7

Job summary

The Utilization Management Nurse Consultant utilizes clinical skills to evaluate healthcare benefits and coordinate care for Medicare members, communicating with providers and recommending appropriate services based on clinical criteria within a remote work setting.

Responsibilities

The Utilization Management Nurse Consultant assesses and coordinates healthcare services by applying clinical criteria to render coverage determinations. They collaborate with providers and internal teams to facilitate appropriate care and identify opportunities for quality improvement.

Qualifications

Clinical Assessment Communication Healthcare Regulations Managed Care Med/Surg MedCompass Medicare Microsoft Office Nursing Utilization Management

Candidates must hold an active, unrestricted RN license with at least 3 years of experience, including 1 year in Med/Surg. Proficiency in Microsoft Office and the ability to maintain a secure, high-speed home office environment are required.

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
Washington, District of Columbia, United States

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Excellent 4.7
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