Utilization Management Nurse Consultant
Clinical Careers Page(1 month ago)
About this role
A Registered Nurse position on CVS Health’s Clinical Predetermination (Utilization Management) team within the company’s national health solutions organization. The role is part of CVS Health’s clinical operations supporting coordinated care and benefits decision-making across digital and local channels. The position is embedded in a 24/7 utilization management function serving members and providers.
Required Skills
- Clinical Assessment
- Utilization Management
- Care Coordination
- Prior Authorization
- Med Surg
- Microsoft Office
- MedCompass
- Managed Care
- Ambulatory Surgery
Qualifications
- Associates Degree
- BSN Preferred
- Active Unrestricted RN License
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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