[Remote] Utilization Management Nurse Consultant - Work at Home at CVS Health

Virginia, Minnesota, United States

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$60,557 – $129,618Compensation

Junior (1 to 2 years)Experience Level

Full TimeJob Type

UnknownVisa

HealthcareIndustries

Requirements

1+ years experience as a Registered Nurse, with an unrestricted license in state of residence
1+ years of clinical experience
Associates or bachelor's degree
Availability for 11-8pm EST M-F schedule

Responsibilities

Supports comprehensive coordination of medical services through composition and auditing of approval, extensions, and denial letters
Promotes and supports quality effectiveness of the healthcare services
Maintains accurate and complete documentation to meet risk management, regulatory, and accreditation requirements
Promotes communication, both internally and externally to enhance effectiveness of medical management services

Skills

Key technologies and capabilities for this role

Registered NurseUtilization ManagementManaged CareMedical Services CoordinationDocumentationGrammarMulti-tasking

Questions & Answers

Common questions about this position

What is the pay range for this Utilization Management Nurse Consultant role?

The typical pay range is $29.10 - $62.32 per hour. The actual base salary will depend on factors like experience, education, and geography, and the position is eligible for a CVS Health bonus, commission, or short-term incentive program.

Is this a remote position, and what are the work hours?

Yes, this is a Work at Home position with hours from 11-8pm EST, Monday through Friday.

What are the required qualifications for this nurse consultant role?

Candidates need 1+ years experience as a Registered Nurse with an unrestricted license in the state of residence, 1+ years of clinical experience, and an Associates or Bachelors degree.

What benefits does CVS Health offer for this position?

Benefits include affordable medical plan options, a 401(k) plan with matching company contributions, employee stock purchase plan, no-cost wellness programs, paid time off, flexible work schedules, family leave, tuition assistance, and more.

What preferred experience will make my application stronger for this role?

Preferred qualifications include Utilization Management experience, Managed Care experience, proficiency in grammar and syntax, and the ability to multi-task.

CVS Health

Comprehensive pharmacy and healthcare services

About CVS Health

CVS Health operates a large network of retail pharmacies and walk-in medical clinics across the United States, providing a variety of health-related products and services. Their offerings include prescription medications, over-the-counter health products, and beauty items, as well as pharmacy benefits management and specialty pharmacy services. CVS Health's integrated business model allows them to serve individual consumers, businesses, and communities effectively, with a focus on improving health outcomes and reducing healthcare costs. Unlike many competitors, CVS Health combines pharmacy services with medical care, making it easier for patients to access quality healthcare. The company's goal is to enhance access to healthcare and support individuals in achieving better health.

Woonsocket, Rhode IslandHeadquarters

1963Year Founded

DEBTCompany Stage

Healthcare, Consumer GoodsIndustries

10,001+Employees

Benefits

Health Insurance

Dental Insurance

Vision Insurance

Life Insurance

Disability Insurance

401(k) Retirement Plan

Company Equity

Wellness Program

Professional Development Budget

Paid Vacation

Paid Holidays

Risks

Legal challenges related to opioid prescriptions could harm CVS's reputation and finances.

The DOJ's intervention in a whistleblower lawsuit may increase legal costs for CVS.

The Horizon Organic Milk recall exposes potential vulnerabilities in CVS's supply chain.

Differentiation

CVS Health operates over 9,600 retail pharmacies and 1,100 walk-in clinics nationwide.

The company integrates pharmacy benefits management with specialty pharmacy services for comprehensive care.

CVS Health offers tailored medication plans through personalized medicine and pharmacogenomics.

Upsides

Expansion of telehealth services allows CVS to reach more patients remotely.

Increased consumer interest in wellness boosts demand for CVS's health-related products.

The trend towards value-based care aligns with CVS's integrated healthcare approach.

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