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Job Information

CVS Health UM Nurse Consultant in Hartford, Connecticut

Job Description

Fully RemoteThe working hours will be Monday-Friday 8am-4:30pm Rotating weekends and holidays No travel is required.Candidates can apply from any stateUtilizes clinical skills to coordinate, document and communicate all aspects of the utilization/benefit management program within the Healthcare Business Solutions Team. Requires an RN with unrestricted active license. Review services to assure medical necessity * Applying clinical expertise to assure appropriate benefit utilization * facilitate safe and efficient discharge planning * work closely with facilities and providers to meet the complex needs of the member. Managed Care experience preferred 3-5 years of clinical experience required

Required Qualifications

RN license required Interacting with Medical ProfessionalsMaximizing Healthcare QualityCollaborating for Results Functional Experience - Nursing - Clinical coverage and policies and Concurrent Review/discharge planning/1-3 YearsTechnical Experience -Desktop Tools - Microsoft Outlook/1-3 Years/End User

COVID Requirements

COVID-19 Vaccination Requirement

CVS Health requires its Colleagues in certain positions to be fully vaccinated against COVID-19 (including any booster shots if required), where allowable under the law, unless they are approved for a reasonable accommodation based on disability, medical condition, pregnancy, or religious belief that prevents them from being vaccinated.

  • If you are vaccinated, you are required to have received at least one COVID-19 shot prior to your first day of employment and to provide proof of your vaccination status within the first 30 days of your employment. For the two COVID-19 shot regimen, you will be required to provide proof of your second COVID-19 shot within the first 60 days of your employment. Failure to provide timely proof of your COVID-19 vaccination status will result in the termination of your employment with CVS Health.

  • If you are unable to be fully vaccinated due to disability, medical condition, pregnancy, or religious belief, you will be required to apply for a reasonable accommodation within the first 30 days of your employment in order to remain employed with CVS Health. As a part of this process, you will be required to provide information or documentation about the reason you cannot be vaccinated. If your request for an accommodation is not approved, then your employment may be terminated.

Preferred Qualifications

Supporting Medical PracticeDriving a Culture of ComplianceProviding Solutions to Constituent Needs

Education

Associate's Degree required, BSN preferred

Business Overview

At Aetna, a CVS Health company, we are joined in a common purpose: helping people on their path to better health. We are working to transform health care through innovations that make quality care more accessible, easier to use, less expensive and patient-focused. Working together and organizing around the individual, we are pioneering a new approach to total health that puts people at the heart.

We are committed to maintaining a diverse and inclusive workplace. CVS Health is an equal opportunity and affirmative action employer. We do not discriminate in recruiting, hiring or promotion based on race, ethnicity, gender, gender identity, age, disability or protected veteran status. 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.

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