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Position Summary

Multiple shifts available.

This is a work at home position and employee can live in any state.

As a Utilization Nurse Consultant you will utilize clinical skills to coordinate, document and communicate all aspects of the utilization/benefit management program. You would be responsible for ensuring the member is receiving the appropriate care at the appropriate time and at the appropriate location, while adhering to federal and state regulated turn-around times. This includes reviewing written clinical records. Looking for someone who is highenergy and motivated team environment and is detail oriented and highly organized.

The UM Nurse Consultant reviews services to assure medical necessity, applies clinical expertise to assure appropriate benefit utilization, facilitates safe and efficient discharge planning and works closely with facilities and providers to meet the complex needs of the member.Required Qualifications- Must have an active, current and unrestricted RN licensure in state of residence

• Minimum of 3 years of acute hospital clinical experience as an RN

• Must be able to work one of the available shifts below:

• Monday-Friday: 9am-5:30pm in time zone of residence

• Monday-Friday: 12:30pm-9pm in time zone of residence

• Both shift options have rotating weekend coverage with hours of 8am-4:30pm EST zone

• Must have MS Office suites experience

Preferred Qualifications

• Utilization Review experience preferred, but not required.

• Any Managed Care background is a plus

• Strong telephonic communication skillsEducationAssociates degree required

BSN preferred

Pay Range

The typical pay range for this role is:

$29.10 - $62.31

This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above. In addition to your compensation, enjoy the rewards of an organization that puts our heart into caring for our colleagues and our communities. The Company offers a full range of medical, dental, and vision benefits. Eligible employees may enroll in the Company’s 401(k) retirement savings plan, and an Employee Stock Purchase Plan is also available for eligible employees. The Company provides a fully-paid term life insurance plan to eligible employees, and short-term and long term disability benefits. CVS Health also offers numerous well-being programs, education assistance, free development courses, a CVS store discount, and discount programs with participating partners. As for time off, Company employees enjoy Paid Time Off (“PTO”) or vacation pay, as well as paid holidays throughout the calendar year. Number of paid holidays, sick time and other time off are provided consistent with relevant state law and Company policies. For more detailed information on available benefits, please visit jobs.CVSHealth.com/benefits

We anticipate the application window for this opening will close on: 04/19/2024

We are an equal opportunity and affirmative action employer. We do not discriminate in recruiting, hiring, promotion, or any other personnel action based on race, ethnicity, color, national origin, sex/gender, sexual orientation, gender identity or expression, religion, age, disability, protected veteran status, or any other characteristic protected by applicable federal, state, or local law.