Advanced Clinical Advocate Nurse Practitioner

CVS Health•New Albany, OH

5d•Remote

About The Position

The Advanced Clinical Advocate Nurse Practitioner (NP) serves as a senior clinical resource supporting providers, members, and internal clinical teams in navigating complex pharmacy- and imaging-related care needs. The role functions as a clinical liaison among providers, pharmacy, imaging, and operational teams to promote timely access to medically appropriate care, facilitate clinical collaboration, and support evidence-based decision-making. The NP engages providers, evaluates complex clinical scenarios, identifies barriers to care, and facilitates appropriate next steps that support quality outcomes and an improved provider experience. This is not a direct patient care role. The NP does not provide retail, primary care, urgent care, or in-home clinical services, and does not conduct in-home assessments. The position focuses on clinical advocacy, provider partnership, healthcare navigation, and improving access to medically appropriate care through collaboration and clinical expertise. This is a work-from-home position. The employee must have or obtain a direct, hardwired internet connection to a modem/router within seven feet of the computer, with a minimum speed of 25 Mbps download and 3 Mbps upload; Wi-Fi and satellite internet are not permitted. The employee must maintain a quiet, secure, private, organized home workspace compliant with CVS Health and HIPAA guidelines, and work within the state and city where they currently live. CVS Health provides equipment such as a keyboard, monitor, computer, and headset; employees provide their own workspace furniture. The role requires extended periods at a desk. The role involves using multiple monitors and applications, digital communication and meeting tools, Microsoft Office 365 or similar applications, secure systems such as VPN and EHR portals, and appropriate computer and password security practices. Employees should be able to troubleshoot common technical issues and remain open to learning new skills as the workplace evolves. The anticipated schedule is 40 hours per week. The typical pay range is $26.01–$74.78, and the position is eligible for a bonus, commission, or short-term incentive program. The full-time benefits package includes medical, dental, and vision coverage, paid time off, retirement savings options, wellness programs, and other resources, subject to eligibility.

Requirements

Active, unrestricted Nurse Practitioner license, with the ability to obtain and maintain multi-state licensure as required.
Current national board certification through ANCC, AANP, or another nationally recognized certifying body.
Minimum of five years of advanced clinical practice experience.
Demonstrated clinical expertise in complex care management, specialty care, managed care, pharmacy, imaging, utilization support, or related healthcare settings.
Strong clinical assessment, critical thinking, and decision-making skills.
Experience collaborating directly with physicians, specialists, and advanced practice providers.
Excellent verbal and written communication skills.
Ability to interpret clinical information, evidence-based guidelines, and healthcare policies to support informed clinical recommendations.
Ability to obtain or maintain a direct, hardwired internet connection with at least 25 Mbps download and 3 Mbps upload; Wi-Fi and satellite internet are not permitted.
Ability to maintain a quiet, secure, private home workspace compliant with CVS Health and HIPAA guidelines and work from the state and city where currently living.
Comfort setting up and using multiple monitors and navigating multiple applications simultaneously.
Ability to communicate through email, calendar invites, Teams messaging, and virtual meetings.
Experience with Microsoft Office 365 applications or similar tools such as Google Workspace.
Ability to access secure systems, follow computer and password security practices, and recognize suspicious emails or links.
Ability to troubleshoot common technical issues independently and contact IT for unresolved issues.
Openness to learning new skills as the workplace environment evolves.

Nice To Haves

Experience supporting pharmacy- and/or imaging-related clinical programs.
Prior managed care, health plan, payer, specialty care, or population health experience.
Experience conducting provider-to-provider clinical consultations.
Familiarity with evidence-based clinical guidelines and clinical decision support tools.
Experience collaborating with Medical Directors and interdisciplinary clinical leadership teams.
Knowledge of healthcare regulations, accreditation standards, and quality improvement methodologies.

Responsibilities

Serve as a clinical resource for complex pharmacy- and imaging-related cases.
Collaborate with providers to clarify clinical needs, treatment intent, and supporting clinical information.
Evaluate clinical scenarios and identify opportunities to support timely access to appropriate care and services.
Apply advanced clinical judgment to support evidence-based decision-making.
Facilitate resolution of complex clinical questions through collaboration with providers, pharmacists, nurses, and interdisciplinary teams.
Conduct clinical outreach and provider-to-provider consultations regarding complex care requests.
Partner with ordering and prescribing providers to understand unique clinical circumstances and treatment goals.
Support productive clinical dialogue that promotes appropriate care planning and informed decision-making.
Build collaborative relationships with provider partners and serve as a trusted clinical resource.
Function as a clinical liaison between pharmacy, imaging, operational, and clinical teams.
Partner with pharmacists, nurses, care teams, and other stakeholders to address complex clinical situations.
Escalate clinically complex cases when additional expertise or review is required.
Support efficient care coordination and reduce unnecessary barriers that may impact treatment initiation.
Promote a seamless provider experience through proactive communication and collaboration.
Identify trends, opportunities, and barriers impacting care access and provider experience.
Provide feedback regarding clinical documentation, workflow opportunities, and process improvement initiatives.
Participate in quality, compliance, and clinical calibration activities.
Contribute to initiatives designed to improve care access, provider satisfaction, and the overall healthcare experience.
Support continuous improvement efforts focused on clinical quality and operational excellence.