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Um Nurse Consultant

https://www.cvshealth.com/ Logo

CVS Health

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Location:
United States , Work at Home

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Category:
Nursing

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Contract Type:
Not provided

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Salary:

29.10 - 62.32 USD / Hour
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Job offer has expired

Job Description:

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time.

Job Responsibility:

  • Utilizes clinical experience and skills in a collaborative process to assess, plan, implement, coordinate, monitor and evaluate options to facilitate appropriate healthcare services/benefits for members
  • Gathers clinical information and applies the appropriate clinical criteria/guideline, policy, procedure and clinical judgment to render coverage determination/recommendation along the continuum of care
  • Communicates with providers and other parties to facilitate care/treatment
  • Identifies members for referral opportunities to integrate with other products, services and/or programs
  • Identifies opportunities to promote quality effectiveness of Healthcare Services and benefit utilization
  • Consults and lends expertise to other internal and external constituents in the coordination and administration of the utilization/benefit management function

Requirements:

  • 2+ years of experience as a Registered Nurse in adult acute care/critical care setting
  • Must have active current and unrestricted RN licensure in state of residence
  • Utilization Management is a 24/7 operation and work schedules will include weekends, holidays
  • Associates Degree required
  • Proficiency with computer skills which includes navigating multiple systems and keyboarding
  • Effective communication skills, both verbal and written

Nice to have:

  • 2+ years of clinical experience required in med surg or specialty area
  • Managed Care experience preferred, especially Utilization Management
  • Preference for those residing in ET zones
  • BSN preferred
What we offer:
  • Affordable medical plan options
  • 401(k) plan (including matching company contributions)
  • Employee stock purchase plan
  • No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching
  • Paid time off
  • Flexible work schedules
  • Family leave
  • Dependent care resources
  • Colleague assistance programs
  • Tuition assistance
  • Retiree medical access

Additional Information:

Job Posted:
March 24, 2026

Expiration:
March 24, 2026

Employment Type:
Fulltime
Work Type:
Remote work
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