CVS Health·6 days ago
6 days ago
UM Nurse Consultant | Post Acute Specialty UM
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What you'll do
- perform utilisation management reviews and authorisation for post-acute services, including Skilled Nursing Facilities and Home Health
- apply independent clinical judgement
- collaborate with multidisciplinary teams
What they're looking for
- registered nurse license
- clinical nursing experience
- expertise in post-acute care
Summarised by NextRaise from the employer’s description, which follows in full below.
Full description from employer
We are looking for a UM Nurse Consultant to perform utilisation management reviews and authorisation for post-acute services, including Skilled Nursing Facilities and Home Health. The role requires independent clinical judgement and collaboration with multidisciplinary teams. Ideal candidates have clinical nursing experience and expertise in post-acute care.
Skills
- registered nurse license
- utilization management
- clinical assessment
- case management
- discharge planning
- medical necessity evaluation
- evidence-based clinical criteria
- skilled nursing facilities
- inpatient rehabilitation facilities
- long-term acute care hospitals
- home health services
- mcg
- electronic medical records
- utilization management platforms
- critical thinking
- clinical judgment
- written communication
- verbal communication
- medicaid utilization management
- medicare utilization management
- commercial health plan utilization management
- remote work
- regulatory requirements
Company
CVS Health
Work at Home, United States of America
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