QM Nurse Associate
12 Nov → 12 Dec
Woonsocket, RI 02895, USA
Working hours will be Monday-Friday 8am-5pm with the ability to work a late shift as needed.
No weekend or travel is required.
Holidays may be required on rotation.
This role is open to Telework anywhere! Preference for candidates in PST, CST or MST.
COVID-19 Vaccination Requirement
CVS Health requires its Colleagues in certain positions to be fully vaccinated against COVID-19 (including any booster shots if required), where allowable under the law, unless they are approved for a reasonable accommodation based on disability, medical condition, pregnancy, or religious belief that prevents them from being vaccinated.
We are committed to maintaining a diverse and inclusive workplace. CVS Health is an equal opportunity and affirmative action employer. We do not discriminate in recruiting, hiring or promotion based on race, ethnicity, gender, gender identity, age, disability or protected veteran status. We proudly support and encourage people with military experience (active, veterans, reservists and National Guard) as well as military spouses to apply for CVS Health job opportunities.
- This critical position supports the Utilization Management Organization Determination (OD) SNF/LTAC/Rehab team
- Utilization of clinical skills to support the documentation and communication of medical services and/or benefit administration determinations.
- Ability to review Medicare pre-service correspondence to assure denial letter language compliance with CMS requirements; the provision of alternate wording when necessary.
- Ability to multitask, prioritize and effectively adapt to a fast paced changing environment
Requirements / Qualifications
- Minimum of 2+ years clinical experience required
- Minimum 1+ year of Medicare experience
- LPN/LVN with current unrestricted state licensure required
How To Apply
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