CVS Health एक अमेरिकी स्वास्थ्य सेवा कंपनी है, जो स्वास्थ्य सेवाओं, स्वास्थ्य बीमा, फार्मेसी लाभ प्रबंधन और रिटेल फार्मेसी के क्षेत्रों में काम करती है। Aetna और CVS Caremark जैसे व्यवसायों के माध्यम से यह स्वास्थ्य कवरेज, दवाओं तक पहुंच, रोग प्रबंधन, विशेष दवाओं और मेल-ऑर्डर फार्मेसी सेवाओं में सहायता प्रदान करती है। इसकी स्थानीय फार्मेसियां और व्यापक स्वास्थ्य सेवाएं लोगों को आवश्यक स्वास्थ्य देखभाल अधिक सुविधाजनक और किफायती तरीके से प्राप्त करने में मदद करने के लिए बनाई गई हैं। CVS Health बीमा, फार्मेसी और स्वास्थ्य सेवाओं को एक साथ लाकर लोगों और समुदायों को उनकी स्वास्थ्य यात्रा के दौरान सहयोग प्रदान करती है।
Remote Utilization Management Nurse Consultant
Review complex Medicare spine cases and make coverage decisions for CVS Health. Coordinate evidence-based care remotely with providers and care teams.
संयुक्त राज्य
अलबामा
एरिज़ोना
कैलिफ़ोर्निया
कोलोराडो
फ़्लोरिडा
आइडाहो
इलिनॉय
आयोवा
केंटकी
लुइज़ियाना
मेन
मैसाचुसेट्स
मिशिगन
मिनेसोटा
मिसिसिपी
नेवादा
न्यू जर्सी
न्यूयॉर्क
उत्तरी कैरोलिना
ओहायो
ओक्लाहोमा
ओरेगन
पेंसिल्वेनिया
दक्षिण कैरोलाइना
टेनेसी
टेक्सास
विस्कॉन्सिन$29 – $62 / घंटा
रिमोटपूर्णकालिकमध्य स्तरवरिष्ठआवश्यक भाषा: अंग्रेज़ीसलाहकारविवरण
- Review clinical cases and determine coverage using evidence-based guidelines.
- Coordinate appropriate treatment with providers and care teams.
- Use clinical judgment to guide utilization and benefit management decisions.
- Identify ways to improve care quality and member outcomes.
- Provide clinical guidance to internal and external stakeholders.
- Apply clinical expertise in a collaborative, non-bedside position.
- Contribute to care coordination and healthcare quality.
आवश्यकताएँ
- Hold an active, unrestricted RN license in your state of residence.
- Have at least three years of RN experience, including at least one year in medical-surgical nursing.
- Demonstrate strong clinical assessment and decision-making skills.
- Have experience with Microsoft Office, including Outlook, Teams, and Excel.
- Be available Monday through Friday, 9:00 a.m. to 5:30 p.m. in your time zone.
- Be able to work some holidays and evening hours; Utilization Management operates 24 hours a day, seven days a week.
- Hold an Associate Degree in Nursing.
- Use a direct, hardwired internet connection to a modem or router within seven feet of the computer.
- Have internet service with at least 25 Mbps download and 3 Mbps upload speeds.
- Do not use Wi-Fi or satellite internet.
- Maintain a quiet, secure, private home workspace that meets CVS Health and HIPAA guidelines.
- Work from the state and city where you currently reside.
- Provide workspace furniture, such as a desk or standing desk.
- Be able to use multiple monitors and navigate multiple applications.
- Be comfortable with digital communications, including email, calendar invitations, Teams messages, and virtual meetings.
- Have experience with Microsoft Office 365 or similar Google Workspace applications.
- Be able to access secure systems, including VPN and EHR portals.
- Follow computer security practices, including locking screens, using strong passwords, and recognizing suspicious emails or links.
- Troubleshoot common technical issues and contact IT when they cannot be resolved.
- Be open to learning new skills as the workplace evolves.
- Utilization Management or prior authorization experience, a managed care background, familiarity with MedCompass, and ambulatory surgery experience are preferred.
- A BSN is preferred.
लाभ
- Eligibility for a CVS Health bonus, commission, or short-term incentive program in addition to base pay.
- Medical coverage.
- Dental coverage.
- Vision coverage.
- Paid time off.
- Retirement savings options.
- Wellness programs.
- Resources supporting physical, emotional, and financial well-being.
- Company-provided equipment, including a keyboard, monitor, computer, and headset.
- Remote work arrangement.