Hybrid Nurse Consultant

at CVS Health

• Job title: Nurse Consultant
• Job type: Full Time
• Experience level: Junior
• Salary: $29 - $62 per hour
• Degree requirement: Associate's Degree
• Location requirements: Hybrid, United States

About the role

• Utilizes clinical skills to assess and coordinate healthcare services in a remote role at CVS Health. Responsible for monitoring and evaluating healthcare services for members in a collaborative process.

Responsibilities

• 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 providers and other parties to facilitate care/treatment.
• Identifies members for referral opportunities to integrate with other products, services and/or benefit programs.
• Identifies opportunities to promote quality effectiveness of Healthcare Services and benefit utilization.
• Consults and lends expertise to other internal and external constituents in the coordination and administration of the utilization/benefit management function.
• Meets set productivity and quality expectations.

Requirements

• Registered Nurse
• Must have active current and unrestricted RN licensure in state of residence.
• May be required to obtain additional Nursing Licenses as business needs require.
• 1+ years of Managed Care Experience; and experience with utilization review
• 1+ years of clinical experience in acute or post-acute setting.
• Diploma RN acceptable; Associate degree/BSN preferred

Benefits

• Affordable medical plan options
• 401(k) plan (including matching company contributions)
• Employee stock purchase plan
• No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.
• Paid time off
• Flexible work schedules
• Family leave
• Dependent care resources
• Colleague assistance programs
• Tuition assistance
• Retiree medical access