Utilization Management Nurse Consultant - FL

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 SummaryFully remote with requirement to reside in Florida.

• Utilization Management is a 24/7 operation and the work schedule may include weekends, holidays, and evening hours.
• Applies critical thinking, evidenced based clinical criteria and clinical practice guidelines for services requiring precertification.
• The majority of the time is spent at a desk and on the phone collecting and reviewing clinical information from providers.
• Precertification nurses use specific criteria to authorize procedures/services or initiate a Medical Director referral as needed.

• Must have active, current and unrestricted RN licensure in Florida
• Must reside in Florida
• 3+ years of clinical experience
• Utilization Management is a 24/7 operation and work schedule may include weekends, holidays, and evening hours.
• 2+ years' experience using personal computer, keyboard navigation, navigating multiple systems and applications; and using MS Office Suite applications (Teams, Outlook, Word, Excel, etc.)

• Previous prior authorization experience
• Prefer RN FL Compact license
• Prior experience working for a health plan or MCO

• Diploma RN or Associates degree in Nursing required
• 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.