CVS Health

Concurrent Review Nurse

Posted on

March 12, 2025

Job Type

Full-Time

Role Type

Telehealth

License

RN

State License

Oklahoma

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Help & Resources

Company Description

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 Behaviorsā„¢ 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.

Job Description

Monday-Friday: 11-8pm ET/10-7pm CT with occasional weekend and holiday coverage per business needs. Requirement to reside in CST or EST zone.

Requirements

Required Qualifications: Current and unrestricted RN license in the state of residence Reside in CST or EST zone Must be willing and able to work Monday through Friday 11-8pm ET/10-7pm CT with occasional weekend and holiday coverage per business needs 2+ year(s) experience using personal computer, keyboard navigation, navigating multiple systems and applications, use of Microsoft office suite applications (Teams, Outlook, Word, Excel, etc. Preferred Qualifications: Managed care experience 1+ year(s) clinical experience Education: Associate's degree in nursing required BSN preferred

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Responsibilities

This is a full-time telework opportunity. This position is for a letter writer/auditor that will support comprehensive medical services through composition and auditing of approval, partial approval, denial, extension, and request for information letters for the Aetna Medicaid centralized letters team. The letter writer/auditor role assists in maintaining accurate and complete documentation to meet risk management, regulatory, and accreditation requirements. The letter writer/auditor will promote positive communication both internally and externally to enhance effectiveness of medical management services.

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