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Prior Authorization Clinician RN (Remote, must be Oklahoma resident)

CVS Health
Edmond, OK, US
$26,01-$56,13 an hour
Remote
Full-time

Bring your heart to CVS Health. Every one of us at CVS Health shares a single, clear purpose : Bringing our heart to every moment of your health.

This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand with heart at its center our purpose sends a personal message that how we deliver our services is just as important as what we deliver.

Our Heart At Work Behaviors™ support this purpose. We want everyone who works at CVS Health to feel empowered by the role they play in transforming our culture and accelerating our ability to innovate and deliver solutions to make health care more personal, convenient and affordable.

This is a full-time telework position.

Hours for this role Monday-Friday 8 am - 5 pm with occasional weekend / holiday on-call

Position Summary

This role is Telework anywhere! Preference for OK residents or out of state residents that have the OK licensure and compact licensure.

Applies critical thinking, evidenced based clinical criteria and clinical practice guidelines for services requiring precertification.

The majority of the time is spent at a desk and on the phone collecting and reviewing clinical information from providers.

Precertification nurses use specific criteria to authorize procedures / services or initiate a Medical Director referral as needed.

Sedentary work involves periods of sitting, talking, listening and computer use

Required Qualifications

  • Must have active, current and unrestricted RN licensure in the state of Oklahoma
  • Must be a resident of Oklahoma
  • 3+ years of clinical experience
  • Must be wiling and able to work Monday - Friday 8 am - 5 pm with occasional weekend / holiday on-call
  • 3+ years of experience working with Microsoft Office suite (Word, Excel, Outlook, etc)

Preferred Qualifications

  • Previous prior authorization experience
  • Compact RN licensure preferred
  • Ability to work in a fast paced environment

Education

  • Associate's degree required
  • BSN preferred

Pay Range

The typical pay range for this role is :

$26.01 - $56.13

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.

The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors.

This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above.

In addition to your compensation, enjoy the rewards of an organization that puts our heart into caring for our colleagues and our communities.

The Company offers a full range of medical, dental, and vision benefits. Eligible employees may enroll in the Company’s 401(k) retirement savings plan, and an Employee Stock Purchase Plan is also available for eligible employees.

The Company provides a fully-paid term life insurance plan to eligible employees, and short-term and long term disability benefits.

CVS Health also offers numerous well-being programs, education assistance, free development courses, a CVS store discount, and discount programs with participating partners.

As for time off, Company employees enjoy Paid Time Off ( PTO ) or vacation pay, as well as paid holidays throughout the calendar year.

Number of paid holidays, sick time and other time off are provided consistent with relevant state law and Company policies.

30+ days ago
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