Quality Management Nurse Consultant

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CVS Health

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Retail • Pharmacy Benefits Management • Health Insurance • Health Care • Pharmacy

10,000+

Description

• Full-time Quality Management Nurse Consultant position in New Jersey • Review and evaluate clinical information and documentation • Interpret data from clinical records to apply clinical criteria • Independently coordinate clinical resolutions with clinician support • Evaluate quality of care issues based on clinical policies • Gather data through multiple system applications • Ensure compliance with clinical policy and regulatory guidelines • Condense complex information into a clear clinical picture • Report findings for improvement as needed

Requirements

• Active and unrestricted RN license in NJ • Willing and able to travel 50% of their time to meet with providers in Northern New Jersey • 3+ years of clinical experience • 2+ years of experience using Microsoft Excel

Benefits

• Full range of medical, dental, and vision benefits • 401(k) retirement savings plan • Employee Stock Purchase Plan • Fully-paid term life insurance • Short-term and long-term disability benefits • Paid Time Off (PTO) or vacation pay • Paid holidays throughout the calendar year • Well-being programs • Education assistance • Free development courses • CVS store discount • Discount programs with participating partners