Address
Form of workPosition Summary
100% remote
Hours: M-F; 8am - 5pm EST, flexible
Holidays:1 major and 1 minor holiday
Weekends: As needed
Applies critical thinking, evidenced based clinical criteria and clinical practice guidelines for procedures/services that do not require precertification.
The majority of the time is spent at a desk and on the phone collecting and reviewing clinical information from providers.
Medicare Predetermination nurses use specific criteria to authorize procedures/services or initiate a Medical Director referral as needed.
Hours will be 8-5pm M-F (in the nurse's time zone) with occasional rotation until 8pm. Minimum holiday and weekend coverage.
Preferred Qualifications
- Clinical precertification/predetermination experience
- Managed care/utilization review experience
- Case Management experience
- Ambulatory surgery center experience
- Position requires proficiency with computer skills which includes navigating multiple systems
- Ability to work in a fast-paced environment
Required Qualifications
- Must have active current and unrestricted Registered Nurse (RN) licensure in state of residence
- 3+ years of clinical experience
- 1+ years of Utilization Management experience
- Must be able to work M-F; 8am - 5pm EST, some flexibility
- Must be willing to work 1 minor and 1 major holiday annually
- Weekend rotation as needed
- Must possess or have the ability to obtain high speed internet access as this is a fully remote position
Business Overview
Bring your heart to CVS Health Every one of us at CVS Health shares a single, clear purpose: Bringing our heart to every moment of your health. This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand - with heart at its center - our purpose sends a personal message that how we deliver our services is just as important as what we deliver. Our Heart At Work Behaviors™ support this purpose. We want everyone who works at CVS Health to feel empowered by the role they play in transforming our culture and accelerating our ability to innovate and deliver solutions to make health care more personal, convenient and affordable. We strive to promote and sustain a culture of diversity, inclusion and belonging every day. CVS Health is an affirmative action employer, and is an equal opportunity employer, as are the physician-owned businesses for which CVS Health provides management services. We do not discriminate in recruiting, hiring, promotion, or any other personnel action based on race, ethnicity, color, national origin, sex/gender, sexual orientation, gender identity or expression, religion, age, disability, protected veteran status, or any other characteristic protected by applicable federal, state, or local law. We proudly support and encourage people with military experience (active, veterans, reservists and National Guard) as well as military spouses to apply for CVS Health job opportunities.
Job Posting Pay Equity Language Part 1
This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors.
Job Posting Pay Equity Language Part 2
In addition to your compensation, enjoy the rewards of an organization that puts our heart into caring for our colleagues and our communities. The Company offers a full range of medical, dental, and vision benefits. Eligible employees may enroll in the Company's 401(k) retirement savings plan, and an Employee Stock Purchase Plan is also available for eligible employees. The Company provides a fully-paid term life insurance plan to eligible employees, and short-term and long term disability benefits. CVS Health also offers numerous well-being programs, education assistance, free development courses, a CVS store discount, and discount programs with participating partners. As for time off, Company employees enjoy Paid Time Off (PTO) or vacation pay, as well as paid holidays throughout the calendar year. Number of paid holidays, sick time and other time off are provided consistent with relevant state law and Company policies.
For more detailed information on available benefits, please visit
jobs.CVSHealth.com/benefits
100% remote
Hours: M-F; 8am - 5pm EST, flexible
Holidays:1 major and 1 minor holiday
Weekends: As needed
Applies critical thinking, evidenced based clinical criteria and clinical practice guidelines for procedures/services that do not require precertification.
The majority of the time is spent at a desk and on the phone collecting and reviewing clinical information from providers.
Medicare Predetermination nurses use specific criteria to authorize procedures/services or initiate a Medical Director referral as needed.
Hours will be 8-5pm M-F (in the nurse's time zone) with occasional rotation until 8pm. Minimum holiday and weekend coverage.
Preferred Qualifications
- Clinical precertification/predetermination experience
- Managed care/utilization review experience
- Case Management experience
- Ambulatory surgery center experience
- Position requires proficiency with computer skills which includes navigating multiple systems
- Ability to work in a fast-paced environment
Required Qualifications
- Must have active current and unrestricted Registered Nurse (RN) licensure in state of residence
- 3+ years of clinical experience
- 1+ years of Utilization Management experience
- Must be able to work M-F; 8am - 5pm EST, some flexibility
- Must be willing to work 1 minor and 1 major holiday annually
- Weekend rotation as needed
- Must possess or have the ability to obtain high speed internet access as this is a fully remote position
Business Overview
Bring your heart to CVS Health Every one of us at CVS Health shares a single, clear purpose: Bringing our heart to every moment of your health. This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand - with heart at its center - our purpose sends a personal message that how we deliver our services is just as important as what we deliver. Our Heart At Work Behaviors™ support this purpose. We want everyone who works at CVS Health to feel empowered by the role they play in transforming our culture and accelerating our ability to innovate and deliver solutions to make health care more personal, convenient and affordable. We strive to promote and sustain a culture of diversity, inclusion and belonging every day. CVS Health is an affirmative action employer, and is an equal opportunity employer, as are the physician-owned businesses for which CVS Health provides management services. We do not discriminate in recruiting, hiring, promotion, or any other personnel action based on race, ethnicity, color, national origin, sex/gender, sexual orientation, gender identity or expression, religion, age, disability, protected veteran status, or any other characteristic protected by applicable federal, state, or local law. We proudly support and encourage people with military experience (active, veterans, reservists and National Guard) as well as military spouses to apply for CVS Health job opportunities.
Job Posting Pay Equity Language Part 1
This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors.
Job Posting Pay Equity Language Part 2
In addition to your compensation, enjoy the rewards of an organization that puts our heart into caring for our colleagues and our communities. The Company offers a full range of medical, dental, and vision benefits. Eligible employees may enroll in the Company's 401(k) retirement savings plan, and an Employee Stock Purchase Plan is also available for eligible employees. The Company provides a fully-paid term life insurance plan to eligible employees, and short-term and long term disability benefits. CVS Health also offers numerous well-being programs, education assistance, free development courses, a CVS store discount, and discount programs with participating partners. As for time off, Company employees enjoy Paid Time Off (PTO) or vacation pay, as well as paid holidays throughout the calendar year. Number of paid holidays, sick time and other time off are provided consistent with relevant state law and Company policies.
For more detailed information on available benefits, please visit
jobs.CVSHealth.com/benefits
