Utilization Management Nurse Consultant - Weekends S/S/M/T (4-10 hour shifts)

CVS Health OpportunityWe're building a world of health around every individual shaping a more connected, convenient and compassionate health experience. At CVS Health, you'll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger helping to simplify health care one person, one family and one community at a time.Position SummaryMedicare Predetermination Utilization Management Nurse Consultant position:Utilization Management is a 24/7 operation and work schedules will include holidays and evening hoursUtilizes 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/treatmentIdentifies members for referral opportunities to integrate with other products, services and/or programsIdentifies opportunities to promote quality effectiveness of Healthcare Services and benefit utilizationConsults and lends expertise to other internal and external constituents in the coordination and administration of the utilization/benefit management function.Required Qualifications3+ years of experience as a Registered NurseMust have active current and unrestricted RN licensure in state of residence1+ years of Med/Surg experience1+ years of experience with Microsoft Office applications (Outlook, Teams, Excel)Must be willing and able to work Saturday, Sunday, Monday and Tuesday 10 hr shifts after approx 4-5 months of training Monday - Friday 7:30am-6pm EST with occasional holiday rotation.Preferred QualificationsPrior Authorization or Utilization Management experienceManaged care experienceExperience using MedCompassAmbulatory surgery experienceMedicare experience is a mustEducationAssociates degree requiredBSN preferredAnticipated Weekly Hours40Time TypeFull timePay RangeThe typical pay range for this role is:$26.01 - $68.55This 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. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above.Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.Great Benefits for Great PeopleWe take pride in offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families.This full?time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial well?being of colleagues and their families. The benefits for this position include medical, dental, and vision coverage, paid time off, retirement savings options, wellness programs, and other resources, based on eligibility.