Appeals Nurse Consultant
Clinical Careers Page(13 days ago)
About this role
A CVS Health® Appeals Nurse Consultant is responsible for reviewing and resolving clinical appeals, ensuring fair and accurate outcomes based on clinical judgment and regulatory requirements. The role involves interpreting clinical documentation and coordinating with internal and external clinicians in a remote work setting.
Required Skills
- Nursing
- Clinical Review
- Regulatory Compliance
- Communication
- Data Interpretation
- Managed Care
- Utilization Review
- Telehealth
- Digital Literacy
- Healthcare Policy
About Clinical Careers Page
cvshealth.comCVS Health is America's leading health solutions company, providing integrated services across retail pharmacy (CVS Pharmacy), pharmacy benefits management (CVS Caremark), and health insurance (Aetna). The company offers pharmacy services, health plans, clinical care (including MinuteClinic), and health-and-wellness programs for consumers, employers, and government payers. By combining a large national retail footprint with claims processing, care management, and clinical services, CVS Health aims to coordinate care, lower costs, and improve health outcomes. Businesses and consumers use its solutions for medication management, plan administration, and in-person and virtual care.
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