Utilization Management Nurse Consultant

Clinical Careers Page(20 days ago)

RemoteFull TimeSenior$58,200 - $124,640Healthcare

About this role

A remote Utilization Management Nurse Consultant at CVS Health assesses and coordinates patient care, reviews medical records, and collaborates with healthcare providers to optimize healthcare resource utilization and ensure appropriate care delivery. The role involves evaluating services to meet medical necessity and developing care strategies in a telehealth environment.

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Required Skills

Nursing
Utilization Review
Medical Records
Care Coordination
Clinical Judgment
Healthcare Benefits
Regulatory Compliance
Healthcare Communication
Digital Literacy
Microsoft Office

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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