UM Nurse Consultant – Rhode IslandRemote @CVS Health posted 4 weeks ago
Works within a small team of Utilization management Subject Matter Experts
Works with SWAT leadership and Health Plan Leadership to address any urgent and/or critical needs of the health plan
Conduct strategic analysis of current data to devise tactical deployment to have a positive impact on the health plans
Fast paced environment
Adaptability is essential
Work collaboratively with areas beyond UM when necessary
Evaluate and implement processes or responses that fall outside of the normal operating procedures, without jeopardizing contractual or regulatory requirements
The typical pay range for this role is:
Please keep in mind that this range represents the pay range for all positions in the job grade within which this position falls. The actual salary offer will take into account a wide range of factors, including location.
Active RN License
2+ years of Medicaid Experience
3+ years of Utilization Management Experience
Experience in multiple areas of UM such as INPT and OP
Bachelor’s degree required
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