Prior Authorization Registered Nurse - Remote

At CVS Health, we're building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care.As the nation's leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues - caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day.Position Summary

This is a fully remote role with a requirement to reside in Oklahoma.

The nurse in this position uses clinical expertise in a collaborative process to assess, plan, implement, coordinate, monitor, and evaluate healthcare services and benefits for members. Responsibilities include gathering clinical information, applying evidence-based guidelines and policies, and using sound clinical judgment to make coverage determinations across the continuum of care.

The role involves regular communication with providers and other stakeholders to facilitate treatment and identify opportunities for referrals to additional programs or services. Nurses also contribute to improving the quality and effectiveness of healthcare services and benefit utilization.

This position requires close review of both handwritten and digital documents, and involves extended periods of sitting, phone communication, and computer use. The ability to multitask, prioritize, and adapt in a fast-paced environment is essential.

• Active, current, and unrestricted Oklahoma RN license
• Minimum of 3 years of clinical nursing experience
• Availability to work 4-10 hour shifts including every weekend (Saturday and Sunday)
• Proficiency in computer navigation and use of multiple systems
• Strong verbal and written communication skills
• Ability to work effectively in a dynamic, fast-paced setting

• Experience in utilization management, precertification, or prior authorization
• Background in managed care

• Associate's Degree in Nursing required
• Bachelor of Science in Nursing (BSN) preferred

• Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan.
• No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.
• Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.