Utilization Management Nurse Consultant

Clinical Careers Page(1 month ago)

RemoteFull TimeMedior$58,200 - $124,640Utilization Management

About this role

The Nurse Consultant on the Utilization Management team applies clinical judgment and evidence-based criteria to review inpatient and outpatient services, collaborating with providers to authorize care and escalate when needed. The role is remote, computer-based, and focused on ensuring appropriate utilization of services and accurate documentation.

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Required Skills

Clinical Judgment
Utilization Management
Prior Authorization
Concurrent Review
Clinical Documentation
Telephone Communication
Multitasking
Authorization
Escalation
Computer Navigation

+1 more

Qualifications

RN License
Associate Degree Nursing (RN)
BSN Preferred

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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