UM Nurse Consultant

The UM Nurse Consultant at CVS Health is responsible for utilizing clinical expertise to review cases, assess medical necessity, and coordinate care within a remote setting. This role is ideal for experienced Registered Nurses looking to impact patient care through utilization management.

• Pay
  : $32.01 - $68.55/hour
• Location
  :
  Remote, NY
• Schedule
  :
  Full-time

• Review clinical information and apply evidence-based criteria to support coverage determinations and care recommendations.
• Collaborate with providers, care teams, and internal partners to coordinate treatment and services.
• Identify opportunities to improve healthcare quality, outcomes, and benefit utilization.
• Refer members to appropriate programs and services that support their overall health needs.
• Serve as a clinical resource for utilization and benefit management questions.

• Education
  • Associate Degree in Nursing required, BSN preferred.
• Experience
  • 2+ years of RN experience in an adult acute care or critical care setting.
• Licenses & Certifications
  • Active, unrestricted RN license in your state of residence required.

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

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