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CVS Health
CVS Health
MaloprodajaZdravstveno varstvoZdravstveno zavarovanje
CVS Health je ameriško zdravstveno podjetje, ki deluje na področju zdravstvenih storitev, zdravstvenega zavarovanja, upravljanja lekarniških ugodnosti in maloprodajnih lekarn. Prek podjetij, kot sta Aetna in CVS Caremark, podpira zdravstveno kritje, dostop do zdravil na recept, obvladovanje zdravstvenih stanj, specializirana zdravila in lekarniške storitve naročanja po pošti. Njegove lokalne lekarne in širša ponudba zdravstvene oskrbe so zasnovane tako, da ljudem omogočajo udobnejši in cenovno dostopnejši dostop do nujno potrebne zdravstvene oskrbe. CVS Health združuje zavarovanje, lekarniške in zdravstvene storitve ter tako podpira posameznike in skupnosti skozi celotno pot njihove zdravstvene oskrbe.
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Delovna mesta v podjetju

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.

USZdružene države AmerikeALAlabamaAZArizonaCAKalifornijaCOKoloradoFLFloridaIDIdahoILIllinoisIAIowaKYKentuckyLALouisianaMEMaineMAMassachusettsMIMichiganMNMinnesotaMSMisisipiNVNevadaNJNew JerseyNYNew YorkNCSeverna KarolinaOHOhioOKOklahomaOROregonPAPensilvanijaSCJužna KarolinaTNTennesseeTXTeksasWIWisconsin
29 $ – 62 $ / ura
Na daljavoPolni delovni časSrednja ravenSeniorZahtevani Jezik: angleščinaKonzultant

Opis

  • 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.

Zahteve

  • 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.

Ugodnosti

  • 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.

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