At CVS Health, we are building a world of health around every consumer with teams that reflect the communities we serve. We’re looking for a Utilization Management Nurse Consultant to join our team remotely. This telework role is open anywhere, with a preference for Virginia residents or out-of-state residents with Virginia or compact licensure.
What You'll Do
- Apply critical thinking, evidence-based clinical criteria, and clinical practice guidelines for services requiring precertification.
- Spend most of your time at a desk and on the phone collecting and reviewing clinical information from providers.
- Use specific criteria to authorize procedures and services or initiate a Medical Director referral as needed.
What We're Looking For
- Active, current, and unrestricted RN licensure in your state of residence.
- At least an Associate’s Degree in nursing.
- 3+ years of clinical nursing experience.
- Proficient computer skills, including navigating multiple systems.
- Ability to work in a fast-paced environment.
Nice to Have
- Residency in Virginia.
- Previous prior authorization experience.
- Compact RN licensure.
- A BSN degree.
Benefits & Compensation
- Compensation range: $29.10 - $62.32 per hour.
- Affordable medical plan options.
- 401(k) plan with matching company contributions.
- Employee stock purchase plan.
- No-cost wellness, counseling, and financial coaching programs.
- Paid time off, flexible schedules, family leave, dependent care resources, tuition assistance, and more.
Work Mode
This is a fully remote position.
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws.
