UM Nurse Consultant

Job DescriptionThis position will be working from home and will require the employee to work M - F 8 - 5pm in their time zone with rare occasions when they'll cover until 8pm. Must have the ability to work on-call rotational coverage on weekends and some rotational on-call holiday coverage as needed- Applies critical thinking, evidenced based clinical criteria and clinical practice guidelines for complex spinal 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.- Position requires proficiency with computer skills which includes navigating multiple systems- Sedentary work involves periods of sitting, talking, listening and computer use- Ability to work in a fast paced environmentPay RangeThe typical pay range for this role is:Minimum: 55,300Maximum: 118,900Please 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.Required Qualifications- 3+ years of experience as a Registered Nurse (RN) with current unrestricted licensure in state of residence- 3+ years of clinical experiencePreferred Qualifications- Clinical precertification experience- Managed care/utilization review experience- Case Management experience- Ambulatory surgery center experienceEducation- Nursing Associate's degree or Nursing diploma acceptable- BSN degree preferredBusiness OverviewBring your heart to CVS Health Every one of us at CVS Health shares a single, clear purpose: Bringing our heart to every moment of your health. This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand - with heart at its center - our purpose sends a personal message that how we deliver our services is just as important as what we deliver. Our Heart At Work Behaviors support this purpose. We want everyone who works at CVS Health to feel empowered by the role they play in transforming our culture and accelerating our ability to innovate and deliver solutions to make health care more personal, convenient and affordable. We strive to promote and sustain a culture of diversity, inclusion and belonging every day. CVS Health is an affirmative action employer, and is an equal opportunity employer, as are the physician-owned businesses for which CVS Health provides management services. We do not discriminate in recruiting, hiring, promotion, or any other personnel action based on race, ethnicity, color, national origin, sex/gender, sexual orientation, gender identity or expression, religion, age, disability, protected veteran status, or any other characteristic protected by applicable federal, state, or local law. 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.

Created: 2025-11-15