Remote Utilization Management Nurse Consultant

CVS Health; Trenton (NJ); Presencial; USD 36 000 - 94 000; Tempo integral

Resumo da oferta

CVS Health is seeking a UM Nurse Consultant in New Jersey to join a 24/7 Utilization Management operation. The role involves clinical assessment, planning and coordinating care, applying guidelines to determine coverage and collaborating with providers to optimize services for members.

You will identify referral opportunities and support cross-functional teams while maintaining HIPAA and security standards.

Qualificações

• 3-5 year(s) of Med/Surg experience.
• 3+ years of experience as an RN.
• 1+ years of inpatient hospital experience.
• Active, current, and unrestricted RN licensure.
• Able to work across multiple IT platforms and MS Office.

Responsabilidades

• Assess, plan, implement, coordinate and evaluate care options to facilitate appropriate services.
• Apply clinical criteria and guidelines to render coverage determinations.
• Communicate with providers and coordinate with internal/external stakeholders.

Conhecimentos

RN licensure

Utilization Management

Clinical assessment

Microsoft Office

Formação académica

Associates Degree

BSN preferred

Ferramentas

Microsoft Office 365

Descrição da oferta de emprego

CVS Health is seeking a UM Nurse Consultant in New Jersey to join a 24/7 Utilization Management operation. The role involves clinical assessment, planning and coordinating care, applying guidelines to determine coverage and collaborating with providers to optimize services for members.

You will identify referral opportunities and support cross-functional teams while maintaining HIPAA and security standards.