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Appeals Nurse Consultant

Job in Norwalk, Fairfield County, Connecticut, 06860, USA
Listing for: CVS Health
Full Time position
Listed on 2026-06-04
Job specializations:
  • Nursing
    Healthcare Nursing, RN Nurse
Salary/Wage Range or Industry Benchmark: 60000 - 80000 USD Yearly USD 60000.00 80000.00 YEAR
Job Description & How to Apply Below

Job Description:

  • Responsible for the review and resolution of clinical appeals
  • Reviews documentation and interprets data obtained from clinical records
  • Independently coordinates the clinical resolution with internal/external clinician support as required
  • Support UM, MPO, Coding, or Behavioral Health appeals.
Requirements:
  • Must have active and unrestricted RN licensure in state of residence
  • 3+ years clinical experience
  • Appeals, Managed Care, or Utilization Review experience preferred
  • Proficiency with computer skills including navigating multiple systems
  • Exceptional communication skills
  • Time efficient, highly organized, and ability to multitask
  • Associate's Degree minimum.
Benefits:
  • Medical, dental, and vision coverage
  • Paid time off
  • Retirement savings options
  • Wellness programs
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