RN Coverage Review Nurse Clinician, Work from Home, reputed company, USA
Job Description - This is a Work at Home role - reputed company in the US Express 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
- Bachelors 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. Thats why youll enjoy a comprehensive range of benefits, with a focus on supporting your whole health.
Starting on day one of your employment, youll be offered several health-reputed company benefits including medical, vision, 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 reputed company Doing something meaningful starts with a simple decision, a commitment to changing lives. At reputed company, were 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.
Qualified applicants will be considered without regard to race, color, 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.
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