Utilization Management Nurse Consultant

CVS Health is looking for a motivated, organized, and experienced Utilization Management Nurse Consultant to join our team. In this role, the successful candidate will be responsible for collecting and assessing patient data, coordinating with payers and providers, and providing clinical and utilization management services in accordance with CVS Health standards.The ideal candidate must possess a valid nursing license and a minimum of 5 years of experience in a clinical healthcare setting. The candidate must also have a thorough understanding of healthcare regulations and utilization management concepts as well as excellent interpersonal and communication skills. The successful candidate will be able to work independently and manage their time efficiently in order to meet goals and deadlines. If you meet the qualifications and are passionate about making a positive impact on the healthcare system, we welcome your application. Responsibilities: Collect and assess patient data to ensure compliance with CVS Health standards. Coordinate with payers and providers to ensure optimal patient care. Provide clinical and utilization management services in accordance with CVS Health standards. Maintain a valid nursing license and a minimum of 5 years of experience in a clinical healthcare setting. Demonstrate a thorough understanding of healthcare regulations and utilization management concepts. Possess excellent interpersonal and communication skills. Manage their time efficiently in order to meet goals and deadlines. Actively participate in team meetings and other professional development activities. Maintain up-to-date knowledge of healthcare regulations and best practices. Ensure compliance with all relevant state and federal regulations. CVS Health is an Equal Opportunity Employer. We celebrate diversity and are committed to creating an inclusive environment for all employees. We do not discriminate based upon race, religion, color, national origin, sex, sexual orientation, gender identity, age, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics.