UM Nurse Consultant

CVS Health Corporation; Louisiana (MO); On-site; USD 54,000 - 117,000; Full time

Job summary

CVS Health is seeking a Nurse Consultant for a remote role focused on inpatient clinical reviews. The position emphasizes collaboration with hospitals and care teams to ensure appropriate levels of care and efficient discharge planning from a non-bedside capacity.

Ideal candidates have 5+ years of inpatient nursing experience, and hold a LA RN license or Compact licensure. Associates degree is required, with a Bachelor's preferred, and ongoing licensure expansion may be required by state rules.

Qualifications

• Associates Degree required; a Bachelor's degree is preferred.
• 5+ years of inpatient clinical nursing experience.
• Active, unrestricted RN license with Louisiana or Compact licensure.
• Willingness to obtain additional state licensure as required.

Responsibilities

• Conduct concurrent reviews for inpatient admissions and continued stays.
• Evaluate clinical documentation and determine medical necessity using established guidelines.
• Collaborate with hospitals, physicians, and care teams to support appropriate levels of care.
• Facilitate timely discharge planning and care transitions.
• Monitor ongoing inpatient treatment and identify opportunities to improve healthcare utilization.
• Communicate recommendations and clinical findings to providers and internal stakeholders.
• Support effective resource utilization while maintaining quality and compliance standards.

Education

Associates Degree; Bachelor's preferred

Job description

About This Role

The UM Nurse Consultant at CVS Health is a remote position ideal for experienced inpatient Registered Nurses looking to leverage their clinical expertise in a non-bedside role. This role involves conducting concurrent reviews and collaborating with healthcare teams to ensure high-quality patient care.

Highlights

• Pay: $26.01 - $56.14/hour
• Location: Remote, LA
• Schedule: Full-time, Monday–Friday, 8:00 AM–5:00 PM CST with occasional weekend and holiday on-call coverage
• Residency: Must reside in Louisiana or have Compact RN licensure

What You'll Do

• Conduct concurrent reviews for inpatient admissions and continued stays
• Evaluate clinical documentation and determine medical necessity using established guidelines
• Collaborate with hospitals, physicians, and care teams to support appropriate levels of care
• Facilitate timely discharge planning and care transitions
• Monitor ongoing inpatient treatment and identify opportunities to improve healthcare utilization
• Communicate recommendations and clinical findings to providers and internal stakeholders
• Support effective resource utilization while maintaining quality and compliance standards

Requirements

Education:

• Associates Degree required, Bachelors preferred

Experience:

• 5+ years of inpatient clinical nursing experience

Licenses & Certifications:

• Active, unrestricted RN license with Louisiana licensure or Compact RN licensure required
• Ability and willingness to obtain additional state licensure as required

Benefits

• Medical, dental, and vision coverage
• Paid time off
• Retirement savings options
• Wellness programs and other resources

About CVS Health

CVS Health is a leading healthcare provider committed to delivering exceptional patient care. They focus on creating a more connected and compassionate health experience for individuals and communities.