Utilization Management Nurse Consultant
| Company | CVS Health |
|---|---|
| Location | Pennsylvania, USA, Delaware, USA, Jackson Township, NJ, USA, Florida, USA, Waterbury, CT, USA, South Carolina, USA, Georgia, USA, Concord, NH, USA, Virginia, USA, Rhode Island, USA, West Virginia, USA, New York, NY, USA, Maryland, USA, North Carolina, USA |
| Salary | $26.01 – $56.14 |
| Type | Full-Time |
| Degrees | Associate’s |
| Experience Level | Mid Level |
Requirements
- Must have active, current and unrestricted RN licensure in state of residence
- 3+ years of clinical experience
- Must be willing and able to work Monday – Friday 8 am – 5 pm with occasional weekend/holiday on-call
- Position requires proficiency with computer skills which includes navigating multiple systems
- Ability to work in a fast paced environment
Responsibilities
- Applies critical thinking, evidenced based clinical criteria and clinical practice guidelines for services requiring precertification
- Collecting and reviewing clinical information from providers
- Authorize procedures/services or initiate a Medical Director referral as needed
Preferred Qualifications
- Previous prior authorization experience
- West Virginia resident preferred
- Compact RN licensure preferred