Utilization Management Nurse Consultant
CVS HealthFull Time
Senior (5 to 8 years)
Candidates must possess a Bachelor's Degree or equivalent work experience and have 4-6 years of relevant work experience. A strong background in learning program management, education, or training within healthcare or utilization management is highly preferred, along with RN, PT, or OT credentials. Experience in developing and delivering training content, utilization review, case management, managed care, and proficiency in MS Office and Excel are also preferred. Job expectations include willingness to work additional hours, travel up to 30%, adhere to security policies, and sit for extended periods at a computer.
The Learning Program Manager - Utilization Management is responsible for organizing, developing, and managing programs to successful completion, including developing and facilitating programs aligned with strategic direction, and maintaining program budgets and operating plans. Key responsibilities include facilitating onboarding, ongoing, and re-education sessions, assessing training effectiveness, gathering feedback, developing program goals and objectives, and enhancing educational materials. The role also involves building comprehensive program plans, engaging with stakeholders, identifying process improvement opportunities, and communicating program status regularly.
Healthcare software and community care solutions
WellSky offers software and services to improve health and community care, making it easier for providers and patients to access and navigate care. Its products, like the WellSky Value Based Care Suite, integrate with Electronic Health Record (EHR) systems to enhance care coordination. WellSky stands out by providing a comprehensive range of solutions, including strategic consulting and revenue cycle management, which help clients operate more efficiently. The company's goal is to enhance care delivery and improve individuals' quality of life through effective solutions.