CVS Health

Compensation

Full Description

Job Description: • Utilizes clinical experience and skills in a collaborative process to assess, plan, implement, coordinate, monitor and evaluate options to facilitate appropriate healthcare services/benefits for members. • Gathers clinical information and applies the appropriate clinical criteria/guideline, policy, procedure and clinical judgment to render coverage determination/recommendation along the continuum of care. • Communicates with providers and other parties to facilitate care/treatment. • Identifies members for referral opportunities to integrate with other products, services and/or programs. • Identifies opportunities to promote quality effectiveness of Healthcare Services and benefit utilization. • Consults and lends expertise to other internal and external constituents in the coordination and administration of the utilization/benefit management function. Requirements: • 3+ years of experience as a Registered Nurse • Must have active current and unrestricted RN licensure in state of residence • 1+ years of Med/Surg experience • 1+ years of experience with Microsoft Office applications (Outlook, Teams, Excel) • Must be willing and able to work Friday, Saturday, Sunday and Monday 10 hr shifts after approx 4-5 months of training • Monday - Friday 8:30-5pm EST with occasional holiday rotation Benefits: • Affordable medical plan options • 401(k) plan (including matching company contributions) • Employee stock purchase plan • No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs • Confidential counseling and financial coaching • Paid time off • Flexible work schedules • Family leave • Dependent care resources • Colleague assistance programs • Tuition assistance • Retiree medical access