Remote Medicare Precertification Nurse Consultant

CVS Health; Alaska; À distance; USD 36 000 - 86 000; Plein temps

Avantages offerts par ce poste

Medical coverage

Dental coverage

Vision coverage

Paid time off

Retirement savings options

Wellness programs

Résumé du poste

CVS Health is hiring a Utilization Management Nurse Consultant (Clinical Precertification RN, Medicare) for a remote, full-time weekday schedule. You will review cases, determine coverage using guidelines, and coordinate care with providers to ensure appropriate treatment and member outcomes.

You’ll bring an active RN license, 3+ years of experience (including 1+ year in Med/Surg), strong clinical judgment, and proficiency with Microsoft Office.

Qualifications

• Active, unrestricted RN license in the state of residence.
• 3+ years of RN experience, including 1+ year in Med/Surg
• Strong clinical assessment and decision-making skills
• Experience with Microsoft Office (Outlook, Teams, Excel)
• Ability to work Monday–Friday, 9:00 AM–6:00 PM in your time zone; 24/7 operations with holidays/evening hours
• Associate Degree in Nursing

Responsabilités

• Review clinical cases and make coverage determinations using evidence-based guidelines
• Collaborate with providers and care teams to coordinate appropriate treatment
• Apply clinical judgment to support utilization and benefit management decisions
• Identify opportunities to improve care quality and member outcomes
• Serve as a clinical resource across internal and external stakeholders

Connaissances

Active RN license

3+ years RN experience

Med/Surg experience

Microsoft Office proficiency

Time-zone aligned schedule

Formation

Associate Degree in Nursing

Outils

Microsoft Office

Description du poste

CVS Health is hiring a Utilization Management Nurse Consultant (Clinical Precertification RN, Medicare) for a remote, full-time weekday schedule. You will review cases, determine coverage using guidelines, and coordinate care with providers to ensure appropriate treatment and member outcomes.

You’ll bring an active RN license, 3+ years of experience (including 1+ year in Med/Surg), strong clinical judgment, and proficiency with Microsoft Office.