UM Nurse Consultant

This is a fully remote position, open to applicants in Iowa.

📋 Description

• Evaluate and analyze clinical data to aid in coverage decisions and care suggestions.

• Utilize clinical guidelines, policies, and professional judgment throughout the care continuum.

• Collaborate with healthcare providers and teams to enhance patient outcomes.

• Recognize opportunities for care management referrals and member assistance programs.

• Encourage effective healthcare utilization and initiatives geared towards quality improvement.

• Execute utilization management clinical reviews and care coordination.

• Remain at a desk for prolonged periods during remote work.

⛳️ Requirements

• Valid, unrestricted RN license in your state of residence.

• At least 2 years of RN experience in adult acute care or critical care environments.

• Excellent communication, multitasking, and computer navigation abilities.

• Availability to work a flexible schedule, including evenings, weekends, and holidays as part of a 24/7 operation.

• Associate's Degree in Nursing is required.

• Preferred: 2+ years of Med-Surg or specialty clinical experience.

• Preferred: Experience in Managed Care and/or Utilization Management.

• Candidates located in CST/MST/PST time zones are preferred.

• BSN is preferred.

• Direct/hardwired internet connection to a modem/router within 7 feet of the computer is required.

• Minimum internet speed of 25 Mbps download and 3 Mbps upload is necessary.

• A quiet, secure, and private designated home workspace compliant with CVS Health and HIPAA regulations is required.

• Must be able to work within the state and city of current residence.

• Ownership of workspace furniture, such as a desk or standing desk, is required.

• Comfortable with setting up and using multiple monitors and navigating various applications concurrently.

• Ability to communicate via email, calendar invites, Teams messaging, and virtual meetings.

• Experience using Microsoft Office 365 applications or similar Google Workspace applications is required.

• Capability to log in to secure systems, including VPN and EHR portals.

• Ability to lock the computer screen when unattended, manage strong passwords, and identify suspicious emails or links.

• Proficient in resolving common technical issues independently.

• Willingness to learn new skills as the work environment evolves.

🏝️ Benefits

• CVS Health bonus, commission, or short-term incentive program in addition to the base salary range.

• Medical coverage.

• Dental coverage.

• Vision coverage.

• Paid time off.

• Retirement savings options.

• Wellness programs.

• Additional resources supporting physical, emotional, and financial well-being.

• Company-provided equipment (keyboard, monitor, computer, headset, etc.).