Remote Prior Authorization Clinician RN - Transforming Healthcare with Compassion

Join our mission to deliver human-centric healthcare and make a difference in the lives of our members! As a Prior Authorization Clinician RN at CVS Health, you will play a vital role in assessing, planning, and coordinating healthcare services to ensure our members receive the best possible care. This hybrid role offers the flexibility to work from our remote office and your home, providing a better work-life balance. With a competitive salary and a range of benefits, we are committed to attracting and retaining top talent in the industry.

At CVS Health, our purpose is to bring our heart to every moment of our members' health. We are dedicated to delivering enhanced, personalized healthcare that is convenient, affordable, and effective. Our Heart At Work Behaviors empower our team members to transform our culture, innovate, and deliver solutions that make healthcare more personal and accessible.

Position Summary

• Utilize your clinical expertise to assess, plan, implement, coordinate, monitor, and evaluate healthcare services and benefits for our members.
• Apply clinical criteria, guidelines, policies, and procedures to render coverage determinations and recommendations.
• Collaborate with providers and other stakeholders to facilitate care and treatment, identifying opportunities to integrate with other products, services, and programs.
• Promote quality effectiveness of healthcare services and benefit utilization, consulting with internal and external constituents to optimize our utilization and benefit management functions.

Requirements

• 3+ years of experience as a Registered Nurse
• Active, current, and unrestricted Oklahoma RN licensure
• Availability to work Monday - Friday, 8:00 am - 5:00 pm CST, with occasional weekends and holidays as needed
• Associate's Degree required; BSN preferred

Preferred Qualifications

• Utilization management, precertification, and prior authorization experience
• Managed Care experience

What We Offer

• Competitive salary ($26.01 - $56.14 per hour)
• Comprehensive benefits package, including medical, dental, and vision coverage
• 401(k) retirement savings plan and Employee Stock Purchase Plan
• Term life insurance, short-term and long-term disability benefits
• Well-being programs, education assistance, and free development courses
• CVS store discount and discount programs with participating partners
• Paid Time Off (PTO) or vacation pay, paid holidays, and sick time

Ready to Apply?

If you are a motivated and compassionate RN looking to make a difference in healthcare, we encourage you to apply now! Apply To This Job