Utilization Management Nurse Consultant

Job description

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. Utilization Nurse Consultant is a 24/7 operation and work schedule may include weekends, holidays, and evening hours. Utilization Nurse Consultant: Fully Remote- WFH: Position Summary: UM Nurse Consultant: Perm Schedule- Sunday-Thursday 9am-6pm EST: Training Schedule-Monday-Friday 8am-5pm EST: Position Summary: UM Nurse Consultant Utilizes clinical experience and skills in a collaborative process to assess, plan, implement, coordinate, monitor and evaluate options to facilitate appropriate healthcare services/benefits for members. Gathers clinical information and applies the appropriate clinical criteria/guideline, policy, procedure and clinical judgment to render coverage determination/recommendation along the continuum of care. Communicates with...