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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 passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. Position Summary Utilization Management is a 24/7 operation and work schedules will include weekends, holidays, and evening hours. Preference for those residing in mountain or pacific time zones. Utilizes clinical experience and skills in a collaborative process to assess, plan, implement, coordinate, monitor and evaluate options to facilitate appropriate healthcare services/benefits for members. Gathers clinical information and applies the appropriate clinical criteria/guideline, policy, procedure and clinical judgment to render coverage determination/recommendation along the continuum of care Communicates with providers and other parties to facilitate care/treatment Identifies members for referral opportunities to integrate with other products, services and/or programs Identifies opportunities to promote quality effectiveness of Healthcare Services and benefit utilization Consults and lends expertise to other internal and external constituents in the coordination and administration of the utilization/benefit management function. Typical office working environment with productivity and quality expectations. Work requires the ability to perform close inspection of hand written and computer generated documents as well as a PC monitor. Sedentary work involving periods of sitting, talking, listening. Work requires sit

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 passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. Do you have a passion for engaging with people and helping them on their journey to better health? Signify Health, part of CVS Health®, is seeking a Part Time Clinician (Nurse Practitioner or Physician Assistant) to provide In-Home Health Evaluations, engaging with people in the comfort of their own homes and helping bridge gaps in care. You’ll play a critical role in building trusted relationships to make people healthier, helping bring flexible, comprehensive and personalized health evaluations right to people’s front doors. Job highlights The visit, which lasts about 45 minutes, allows for time to connect one-on-one and answer health questions. It includes a medication and medical history review, a physical evaluation, and, if ordered by the person’s health plan, additional diagnostic tests (i.e., diabetic eye exams, spirometry, etc.). You’ll use an iPad and an intuitive clinical workflow for each evaluation and are not required to prescribe medicine, order lab tests or alter people’s current treatment regimen. In this role, you will: Bring your heart into every visit, joining a national network of purpose-driven clinicians dedicated to improving health outcomes Be part of our efforts to visit millions of people nationwide with the goal of providing

C
10 days ago

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 passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. Utilization Management Nurse Consultant Clinical Precertification RN (Medicare) Remote | Full-Time | Weekday Schedule Are you a Registered Nurse ready to make an impact beyond the bedside? Join our team and use your clinical expertise to ensure members receive the right care at the right time. What You’ll Do Review clinical cases and make coverage determinations using evidence-based guidelines Collaborate with providers and care teams to coordinate appropriate treatment Apply clinical judgment to support utilization and benefit management decisions Identify opportunities to improve care quality and member outcomes Serve as a clinical resource across internal and external stakeholders What You Bring - REQUIRED Active, unrestricted RN license in the state of residence. 3&#43; years of RN experience, including 1&#43; year in Med/Surg Strong clinical assessment and decision-making skills Experience with Microsoft Office (Outlook, Teams, Excel) Ability to work Monday–Friday, 9:00 AM–6:00 PM in your time zone. Utilization Management is a 24/7 operation and work schedules will include holidays and evening hours Associate Degree in Nursing Nice to Have Utilization Management or Prior Authorization experience Managed care background</l

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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 passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. Position Summary: The Complex Nurse Case Manager is responsible for assessing members through regular and consistent in person or telephonic contact to assess, plan, implement and coordinate all case management activities with members to evaluate the medical and psychosocial needs of the member to facilitate and support the member’s improved health. The Case Manager develops a proactive course of action to address issues presented to enhance the short and long-term outcomes as well as opportunities to enhance a member’s overall wellness. Services strategies policies and programs are comprised of network management and clinical coverage policies. This is a field-based position that requires routine regional in-state travel 80-90% of the time; use of personal vehicle is required. Qualified candidates must have valid KY driver's license, proof of vehicle insurance, and reliable transportation. Travel to the Louisville office is also anticipated for meetings and training. This position is assigned to the Two Rivers Region. Qualified candidates must reside in one of the counties within Two Rivers (Union, Webster, Henderson, Daviess, Hancock, McLean, Ohio, Butler, Edmonson, Hart, Warren, Logan, Simpson, Allen, Monroe, Metcalfe, Barren). Evaluation of Members: Through the use of clinical assessment tools and evaluating information/data review, conducts a comprehensi

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 passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. Do you have a passion for engaging with people and helping them on their journey to better health? Discover a meaningful role where you’ll engage with health plan members primarily online, helping to close gaps in care. Signify Health, part of CVS Health®, is hiring full-time, board-certified nurse practitioners or physician assistants to conduct Video Visits for Medicare Advantage, Medicaid, and certain commercial plan members. During our Video Visits, you’ll conduct an approximately 30-minute visit, including a medication and medical history review, allowing time to educate members about their health and answer their questions. In this role, you will: Conduct online “Video Visits” with health plan members, working in a private space with adequate internet connection Be part of our efforts to visit millions of people nationwide with the goal of providing connections to the right care for people’s unique needs Provide 40 hours of availability weekly, consistently providing 320&#43; capacity units per month Execute a strong visit completion rate, consistently pacing 220&#43; completed visits per month Maintain training, affiliation, and compliance with Video Visit requirements (regular training required) Other role expectations and requirements: Be trained and credenti

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 passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. Do you have a passion for engaging with people and helping them on their journey to better health? Signify Health, part of CVS Health®, is seeking a Part Time Clinician (Nurse Practitioner or Physician Assistant) to provide In-Home Health Evaluations, engaging with people in the comfort of their own homes and helping bridge gaps in care. You’ll play a critical role in building trusted relationships to make people healthier, helping bring flexible, comprehensive and personalized health evaluations right to people’s front doors. Job highlights The visit, which lasts about 45 minutes, allows for time to connect one-on-one and answer health questions. It includes a medication and medical history review, a physical evaluation, and, if ordered by the person’s health plan, additional diagnostic tests (i.e., diabetic eye exams, spirometry, etc.). You’ll use an iPad and an intuitive clinical workflow for each evaluation and are not required to prescribe medicine, order lab tests or alter people’s current treatment regimen. In this role, you will: Bring your heart into every visit, joining a national network of purpose-driven clinicians dedicated to improving health outcomes Be part of our efforts to visit millions of people nationwide with the goal of providing connections to the right care for people’s unique needs Work

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 passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. Do you have a passion for engaging with people and helping them on their journey to better health? Signify Health, part of CVS Health®, is seeking a Full Time Clinician (Nurse Practitioner or Physician Assistant) to provide In-Home Health Evaluations, engaging with people in the comfort of their own homes and helping bridge gaps in care. You’ll play a critical role in building trusted relationships to make people healthier, helping bring flexible, comprehensive and personalized health evaluations right to people’s front doors. Job highlights The visit, which lasts about 45 minutes, allows for time to connect one-on-one and answer health questions. It includes a medication and medical history review, a physical evaluation, and, if ordered by the person’s health plan, additional diagnostic tests (i.e., diabetic eye exams, spirometry, etc.). You’ll use an iPad and an intuitive clinical workflow for each evaluation and are not required to prescribe medicine, order lab tests or alter people’s current treatment regimen. In this role, you will: Bring your heart into every visit, joining a national network of purpose-driven clinicians dedicated to improving health outcomes Be part of our efforts to visit millions of people nationwide with the goal of providing connections to the right care for people’s unique needs Work with Signify Health as a clinician colleague, fulfilling

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 passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. Do you have a passion for engaging with people and helping them on their journey to better health? Signify Health, part of CVS Health®, is seeking a Full Time Clinician (Nurse Practitioner or Physician Assistant) to provide In-Home Health Evaluations, engaging with people in the comfort of their own homes and helping bridge gaps in care. You’ll play a critical role in building trusted relationships to make people healthier, helping bring flexible, comprehensive and personalized health evaluations right to people’s front doors. Job highlights The visit, which lasts about 45 minutes, allows for time to connect one-on-one and answer health questions. It includes a medication and medical history review, a physical evaluation, and, if ordered by the person’s health plan, additional diagnostic tests (i.e., diabetic eye exams, spirometry, etc.). You’ll use an iPad and an intuitive clinical workflow for each evaluation and are not required to prescribe medicine, order lab tests or alter people’s current treatment regimen. In this role, you will: Bring your heart into every visit, joining a national network of purpose-driven clinicians dedicated to improving health outcomes Be part of our efforts to visit millions of people nationwide with the goal of providing connections to the right care for people’s unique needs Work with Signify Health as a clinician colleague, fulfilling

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 passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. Do you have a passion for engaging with people and helping them on their journey to better health? Signify Health, part of CVS Health®, is seeking a Part Time Clinician (Nurse Practitioner or Physician Assistant) to provide In-Home Health Evaluations, engaging with people in the comfort of their own homes and helping bridge gaps in care. You’ll play a critical role in building trusted relationships to make people healthier, helping bring flexible, comprehensive and personalized health evaluations right to people’s front doors. Job highlights The visit, which lasts about 45 minutes, allows for time to connect one-on-one and answer health questions. It includes a medication and medical history review, a physical evaluation, and, if ordered by the person’s health plan, additional diagnostic tests (i.e., diabetic eye exams, spirometry, etc.). You’ll use an iPad and an intuitive clinical workflow for each evaluation and are not required to prescribe medicine, order lab tests or alter people’s current treatment regimen. In this role, you will: Bring your heart into every visit, joining a national network of purpose-driven clinicians dedicated to improving health outcomes Be part of our efforts to visit millions of people nationwide with the goal of providing connections to the right care for people’s unique needs Work with Signify Health as a clinician colleague, fulfilling

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 passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. Do you have a passion for engaging with people and helping them on their journey to better health? Signify Health, part of CVS Health®, is seeking a Full Time Clinician (Nurse Practitioner or Physician Assistant) to provide In-Home Health Evaluations, engaging with people in the comfort of their own homes and helping bridge gaps in care. You’ll play a critical role in building trusted relationships to make people healthier, helping bring flexible, comprehensive and personalized health evaluations right to people’s front doors. Job highlights The visit, which lasts about 45 minutes, allows for time to connect one-on-one and answer health questions. It includes a medication and medical history review, a physical evaluation, and, if ordered by the person’s health plan, additional diagnostic tests (i.e., diabetic eye exams, spirometry, etc.). You’ll use an iPad and an intuitive clinical workflow for each evaluation and are not required to prescribe medicine, order lab tests or alter people’s current treatment regimen. In this role, you will: Bring your heart into every visit, joining a national network of purpose-driven clinicians dedicated to improving health outcomes Be part of our efforts to visit millions of people nationwide with the goal of providing connections to the right care for people’s unique needs Work with Signify Health as a clinician colleague, fulfilling

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 passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. Do you have a passion for engaging with people and helping them on their journey to better health? Signify Health, part of CVS Health®, is seeking a Part Time Clinician (Nurse Practitioner or Physician Assistant) to provide In-Home Health Evaluations, engaging with people in the comfort of their own homes and helping bridge gaps in care. You’ll play a critical role in building trusted relationships to make people healthier, helping bring flexible, comprehensive and personalized health evaluations right to people’s front doors. Job highlights The visit, which lasts about 45 minutes, allows for time to connect one-on-one and answer health questions. It includes a medication and medical history review, a physical evaluation, and, if ordered by the person’s health plan, additional diagnostic tests (i.e., diabetic eye exams, spirometry, etc.). You’ll use an iPad and an intuitive clinical workflow for each evaluation and are not required to prescribe medicine, order lab tests or alter people’s current treatment regimen. In this role, you will: Bring your heart into every visit, joining a national network of purpose-driven clinicians dedicated to improving health outcomes Be part of our efforts to visit millions of people nationwide with the goal of providing connections to the right care for people’s unique needs Work with Signify Health as a clinician colleague, fulfilling

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 passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. Do you have a passion for engaging with people and helping them on their journey to better health? Signify Health, part of CVS Health®, is seeking a Full Time Clinician (Nurse Practitioner or Physician Assistant) to provide In-Home Health Evaluations, engaging with people in the comfort of their own homes and helping bridge gaps in care. You’ll play a critical role in building trusted relationships to make people healthier, helping bring flexible, comprehensive and personalized health evaluations right to people’s front doors. Job highlights The visit, which lasts about 45 minutes, allows for time to connect one-on-one and answer health questions. It includes a medication and medical history review, a physical evaluation, and, if ordered by the person’s health plan, additional diagnostic tests (i.e., diabetic eye exams, spirometry, etc.). You’ll use an iPad and an intuitive clinical workflow for each evaluation and are not required to prescribe medicine, order lab tests or alter people’s current treatment regimen. In this role, you will: Bring your heart into every visit, joining a national network of purpose-driven clinicians dedicated to improving health outcomes Be part of our efforts to visit millions of people nationwide with the goal of providing connections to the right care for people’s unique needs Work with Signify Health as a clinician colleague, fulfilling

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 passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. Do you have a passion for engaging with people and helping them on their journey to better health? Signify Health, part of CVS Health®, is seeking a Part Time Clinician (Nurse Practitioner or Physician Assistant) to provide In-Home Health Evaluations, engaging with people in the comfort of their own homes and helping bridge gaps in care. You’ll play a critical role in building trusted relationships to make people healthier, helping bring flexible, comprehensive and personalized health evaluations right to people’s front doors. Job highlights The visit, which lasts about 45 minutes, allows for time to connect one-on-one and answer health questions. It includes a medication and medical history review, a physical evaluation, and, if ordered by the person’s health plan, additional diagnostic tests (i.e., diabetic eye exams, spirometry, etc.). You’ll use an iPad and an intuitive clinical workflow for each evaluation and are not required to prescribe medicine, order lab tests or alter people’s current treatment regimen. In this role, you will: Bring your heart into every visit, joining a national network of purpose-driven clinicians dedicated to improving health outcomes Be part of our efforts to visit millions of people nationwide with the goal of providing connections to the right care for people’s unique needs Work with Signify Health as a clinician colleague, fulfilling

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 passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. Do you have a passion for engaging with people and helping them on their journey to better health? Signify Health, part of CVS Health®, is seeking a Part Time Clinician (Nurse Practitioner or Physician Assistant) to provide In-Home Health Evaluations, engaging with people in the comfort of their own homes and helping bridge gaps in care. You’ll play a critical role in building trusted relationships to make people healthier, helping bring flexible, comprehensive and personalized health evaluations right to people’s front doors. Job highlights The visit, which lasts about 45 minutes, allows for time to connect one-on-one and answer health questions. It includes a medication and medical history review, a physical evaluation, and, if ordered by the person’s health plan, additional diagnostic tests (i.e., diabetic eye exams, spirometry, etc.). You’ll use an iPad and an intuitive clinical workflow for each evaluation and are not required to prescribe medicine, order lab tests or alter people’s current treatment regimen. In this role, you will: Bring your heart into every visit, joining a national network of purpose-driven clinicians dedicated to improving health outcomes Be part of our efforts to visit millions of people nationwide with the goal of providing connections to the right care for people’s unique needs Work with Signify Health as a clinician colleague, fulfilling

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 passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. Registered Nurse must hold a CDCES- Certified Diabetes Care and Education Specialist This is a full-time telework role for a RN who resides in a compact state and holds a compact license. Working schedule: Monday-Friday, standard business hours, including 1 evening shift per week from 12:30- pm EST -The Health Coach Consultant utilizes a collaborative process of assessment, planning, implementation and evaluation, to engage, educate, and promote and influence member's decisions related to achieving and maintaining optimal health status for chronic conditions. - Assessment of members through the use of clinical tools and information/data review, conducts comprehensive evaluation of member's needs and benefit plan eligibility for available integrated internal and external programs/services. -Utilizes assessment techniques to determine member's level of health literacy, technology capabilities, and/or readiness to change. -Enhancement of Medical Appropriateness & Quality of Care: -Application and/or interpretation of applicable criteria and guidelines, health/wellness management plans, policies, procedures, regulatory standards while assessing benefits and/or member's needs to enable appropriate utilization of services and/or administration and integration with available internal/external programs. -Usi

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