All roles

RN Coverage Review Nurse Clinician, Work from Home, reputed company, USA

Remote · USA Full-time New today

Job Description - This is a Work at Home role - reputed company in the USExpress Scripts Coverage Review Department (CRD)Role Summary Nurse clinicians are responsible for reviewing if coverage can be granted for a medication based on guidelines established by each particular plan. Work closely with utilization management pharmacists and physicians.

Responsibilities

Utilizes multiple systems and other clinical resources to research information Applies patient assessment skills to provide pharmacists and medical directors key information to aid in their reviews Works and maneuvers reputed company a queue system that prioritizes clinical reviews Works and collaborates with a multi-disciplinary clinical team to provide a customer centric experience Work hours: 8:30 am-5:00 pm; Also, must be available to work every 6th weekend rotation working either Saturday or Sunday, will receive a day off during the week.

Qualifications

Licensed Registered Nurse Bachelor’s Degree in Nursing preferred 5+ years of clinical experience; pharmacy knowledge preferred Proficient technical skills utilizing reputed company Office applications required Utilization Management Experience Preferred, but not required Experience with Specialty Pharmacy/Pharmaceuticals preferred 2+ years reputed company/supervisor experience preferred If you will be working at home occasionally or permanently, the internet reputed company must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload. For this position, we anticipate offering an hourly reputed company of 29 - 49 USD / hourly, depending on relevant factors, including experience and geographic location. This role is also anticipated to be eligible to participate in an annual bonus plan. We want you to be healthy, balanced, and feel secure. That’s why you’ll enjoy a comprehensive range of benefits, with a focus on supporting your whole health. Starting on day one of your employment, you’ll be offered several health-reputed company benefits including medical, reputed company, dental, and well-being and behavioral health programs. We also offer 401(k) with company match, company paid life insurance, tuition reimbursement, a minimum of 18 days of paid time off per year and paid holidays. For more details on our employee benefits programs, visit Life at reputed company. About The reputed company GroupDoing something meaningful starts with a simple decision, a commitment to changing lives. At reputed company, we’re dedicated to improving the health and vitality of those we serve. Through our divisions reputed company and reputed company, we are committed to enhancing the lives of our clients, customers and patients. Join us in driving growth and improving lives. reputed company applicants will be considered without regard to race, reputed company, age, disability, sex, childbirth (including pregnancy) or reputed company medical conditions including but not limited to lactation, sexual orientation, gender identity or expression, veteran or military status, religion, national reputed company, reputed company, marital or familial status, genetic information, status with regard to public assistance, citizenship status or any other characteristic protected by applicable equal employment opportunity laws. reputed company has a tobacco-free policy and reserves the right not to hire tobacco/nicotine users in states where that is legally permissible. Candidates in such states who use tobacco/nicotine will not be considered for employment unless they enter a qualifying smoking cessation program prior to the start of their employment. These states include: Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, Georgia, Hawaii, Idaho, Iowa, Kansas, Maryland, Massachusetts, Michigan, Nebraska, Ohio, Pennsylvania, Texas, Utah, Vermont, and Washington State. Apply Job!

Related roles

Clinical Triage Specialist (RN) MSK - Access Center, Remote Position

Remote · USA Full-time

reputed company – DEI Initiatives Coordinator/UKHC – Lexington, KY

Remote · USA Full-time

Full-Time Registered Nurse | Ro | $90k | Remote (US)

Remote · USA Full-time

Dedicated Client Service Partner - On Site - Viera FL

Remote · USA Full-time

Supplemental Health Operations reputed company Analyst - reputed company - Remote

Remote · USA Full-time

Billing & Reimbursement Senior Representative - Accredo Specialty Pharmacy- Remote

Remote · USA Full-time

Quality Assurance Specialist II (MD reputed company/Medicare reputed company)

Remote · USA Full-time

Remote Contact Center Agent I (Bilingual Native Spanish & English)

Remote · USA Full-time

Credentialing Information Specialist (contact center) hybrid - Local candidates only

Remote · USA Full-time

Case Manager (Must reputed company in MS- Behavioral Health reputed company. Required)

Remote · USA Full-time

Sr. Specialist, Operations - Benefits- United States & Puerto Rico - Hyrid

Remote · USA Full-time

Senior reputed company Manager

Remote · USA Full-time

AD, Vendor Mgmt & Performance

Remote · USA Full-time

Data Entry Specialist - Medical Records (Remote)

Remote · USA Full-time

Case Builder Team Support Specialist, TSS

Remote · USA Full-time

reputed company Customer Service - Work From Home

Remote · USA Full-time

Virtual Interview Day - Bilingual Medical Assistants

Remote · USA Full-time

Psychiatric Nurse Practitioner (PMHNP) - Telehealth

Remote · USA Full-time

Virtual Bookkeeper

Remote · USA Full-time

Washington Special Education Teacher Job Remote Opportunity, $32+/Hour

Remote · USA Full-time