Utilization Management Nurse Consultant - CVS : Job Details

100% remote position from anywhere in the U.S. Work hours: 11:30 am-8:00 pm EST, Monday-Friday. Weekend/holiday coverage will occasionally be required .00% attendance is required during the first 3 weeks of training / 8:30 am-5 pm EST, Monday-Friday. American Health Holding, Inc (AHH) is a medical management company that is a division within Aetna/ CVS Health. Founded in 1993, AHH is URAC accredited in Case Management, Disease Management and Utilization Management. AHH delivers flexible medical management services that support cost-effective quality care for members. Work in clinical telephone queue for 3 to 4 hours a day working with providers to secure additional information for prior authorization review. This candidate will utilize clinical skills to coordinate, document and communicate all aspects of the utilization/benefit management program. Utilizes clinical experience and skills in a collaborative process to assess, plan, implement, coordinate, monitor and evaluate options to ...Management, Nurse, Consultant, Healthcare, Clinical, Retail