Utilization Management Clinical Nurse Consultant - Prior Authorization

Clinical Careers Page(26 days ago)

RemoteFull TimeMedior$52,020 - $149,560Utilization Management

About this role

The Utilization Management Clinical Nurse Consultant - Prior Authorization is a licensed registered nurse who supports the utilization/benefit management program by applying clinical expertise and judgment to ensure appropriate access to covered services. The role partners with clinical and administrative teams to support policy-driven decisions and promote member-centered care across the continuum.

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Required Skills

Clinical Assessment
Prior Authorization
Utilization Management
Care Coordination
Medical Necessity
Discharge Planning
Evidence-Based Care
Clinical Documentation
Communication
Patient Advocacy

Qualifications

Associate's Degree
BSN (Preferred)
Active RN License - Arizona
Compact RN License

About Clinical Careers Page

cvshealth.com

CVS 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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