# Nurse Consultant

**Company**: American Health Holding, Inc. (AHH)
**Location**: Work from home, AZ
**Work arrangement**: remote
**Experience**: senior
**Job type**: full-time
**Salary**: $29.10 - $62.32
**Category**: Healthcare
**Industry**: Healthcare

**Apply**: https://cvshealth.wd1.myworkdayjobs.com/en-US/CVS_Health_Careers/job/AZ---Work-from-home/Utilization-Management-Nurse-Consultant---Behavioral-Health--Remote-_R1086695?utm_source=yubhub.co&utm_medium=jobs_feed&utm_campaign=apply
**Canonical**: https://yubhub.co/job/nurse-consultant-8bcb775a-f83/

## Description

We're building a world of health around every individual , shaping a more connected, convenient and compassionate health experience.

At CVS Health®, you'll be surrounded by colleagues who care deeply, innovate with purpose, hold themselves accountable and prioritize safety and quality in everything we do.

Join our Utilization Management team as a Nurse Consultant, where you'll apply clinical judgment and evidence-based criteria to review inpatient and outpatient services.

**Key Responsibilities**

- Apply critical thinking and evidenced-based clinical criteria to authorise procedures/services or initiate a Medical Director referral as needed.

- Use specific criteria to authorise procedures/services or initiate a Medical Director referral as needed.

- Collaborate with providers, authorise care, and escalate cases when needed, all while navigating multiple systems and maintaining accurate documentation.

- Participate in occasional on-call rotational coverage on weekends and some rotational on-call holiday coverage.

**Remote Work Expectations**

- This is a 100% remote role; candidates must have a dedicated workspace free of interruptions.

- Dependents must have separate care arrangements during work hours, as continuous care responsibilities during shift times are not permitted.

**Required Qualifications**

- Active unrestricted state Registered Nurse licensure in state of residence required.

- 3+ years of acute behavioural health and/or substance abuse clinical nursing experience.

- 1+ year of concurrent review or prior authorisation preferably in Behavioural Health and Substance Abuse.

- Commitment to attend a mandatory 3-week training with 100% participation.

**Preferred Qualifications**

- 1+ years Managed Care (MCO) experience.

- 1+ year demonstrated experience working in a high-volume clinical call centre environment.

- Remote work experience.

**Education**

- Associate's degree in nursing (RN) required, BSN preferred.

**Anticipated Weekly Hours**

40

**Time Type**

Full time

**Pay Range**

$29.10 - $62.32

This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls.

**Benefits**

We take pride in offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families.

This full-time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial well-being of colleagues and their families.

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## Skills

### Required
- Registered Nurse licensure
- clinical judgment
- evidence-based criteria
- utilization management

### Nice to have
- Managed Care experience
- clinical call centre experience
- remote work experience

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Source: [Apply at cvshealth.wd1.myworkdayjobs.com](https://cvshealth.wd1.myworkdayjobs.com/en-US/CVS_Health_Careers/job/AZ---Work-from-home/Utilization-Management-Nurse-Consultant---Behavioral-Health--Remote-_R1086695?utm_source=yubhub.co&utm_medium=jobs_feed&utm_campaign=apply)