Utilization Management Nurse Consultant - Remote
About the position
Responsibilities
• Utilizes clinical experience to assess and facilitate appropriate healthcare services for members.
• Gathers clinical information to render precertification coverage determinations.
• Communicates with providers and other parties to facilitate care and treatment.
• Identifies members for referral opportunities to integrate with other products and services.
• Promotes benefit utilization opportunities.
Requirements
• 3+ years of acute experience as a Registered Nurse.
• Active current and unrestricted RN licensure in state of residence.
• 1+ year(s) of experience with MS Office suites.
Nice-to-haves
• Managed Care experience
• Medicare experience
Benefits
• Full range of medical, dental, and vision benefits.
• 401(k) retirement savings plan.
• Employee Stock Purchase Plan.
• Fully-paid term life insurance plan.
• Short-term and long-term disability benefits.
• Well-being programs.
• Education assistance and free development courses.
• CVS store discount and discount programs with partners.
• Paid Time Off (PTO) and paid holidays.
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