Utilization Management Nurse Consultant

Clinical Careers Page(1 month ago)

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

About this role

A Clinical Precertification Nurse in the Special Case Precert Unit at CVS Health supports the organization’s utilization management functions by managing complex precertification cases as part of the company's clinical operations. The role is embedded within CVS Health’s health solutions organization and interfaces with providers and other internal teams to support member care across settings.

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Required Skills

Clinical Assessment
Care Coordination
Prior Authorization
Utilization Management
Medical Records
Microsoft Office
Med/Surg
MedCompass
Ambulatory Surgery
Provider Communication

+2 more

Qualifications

Associate Degree
Bachelor's in Nursing (Preferred)
Active 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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