CVS Health is hiring a Utilization Management Nurse Consultant to apply clinical experience in a collaborative process to assess, plan, and coordinate appropriate healthcare services for members. This is a full-time weekend position requiring 20 of the 40 hours to be worked on Saturday and Sunday.
What You'll Do
- Gather clinical information and apply appropriate criteria, policy, and clinical judgment to render coverage determinations.
- Communicate with providers and other parties to facilitate care and treatment.
- Identify members for referral opportunities to integrate with other products and programs.
- Identify opportunities to promote quality effectiveness of Healthcare Services and benefit utilization.
- Consult and lend expertise to other internal and external constituents in the coordination of the utilization management function.
What We're Looking For
- 3+ years of experience as a Registered Nurse.
- Active, current, and unrestricted RN licensure in your state of residence.
- 1+ years of clinical experience in an acute or post-acute setting.
- Availability to work four 10-hour shifts either Thursday-Sunday or Saturday-Tuesday in your time zone (Monday-Friday earliest start at 7am, weekends at 6am).
- Willingness to work some holidays as required.
- Ability to obtain a California RN license within 6 months of hire.
Nice to Have
- 3+ years of clinical experience.
- Managed Care experience.
Benefits & Compensation
- Hourly compensation: $29.10 - $62.32
- 12.5% shift differential
- Affordable medical plan options.
- 401(k) plan including matching company contributions.
- Employee stock purchase plan.
- No-cost programs including wellness screenings, tobacco cessation, weight management, counseling, and financial coaching.
- Paid time off, flexible work schedules, family leave, dependent care resources, tuition assistance, retiree medical access, and many other benefits.
Work Mode
This is an onsite position.
CVS Health is an equal opportunity employer. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all applicable laws.
