Advanced Clinical Advocate Nurse Practitioner

CVS Health•New Albany, OH

7d•$26 - $75•Remote

About The Position

The Advanced Clinical Advocate Nurse Practitioner (NP) is a senior clinical resource who supports providers, members, and internal clinical teams in navigating complex pharmacy- and imaging-related care needs. The role serves 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 decisions. The NP engages providers, evaluates complex clinical scenarios, identifies barriers to care, and facilitates appropriate next steps to support quality outcomes and an improved provider experience. This is not a direct patient care role. The position does not provide retail, primary care, urgent care, or in-home clinical services, and does not conduct in-home assessments. It focuses on clinical advocacy, provider partnership, healthcare navigation, improving access to care, and supporting high-quality outcomes through collaboration and clinical expertise. The position is work from home. The colleague must work from the state and city where they have confirmed they live, have or obtain a direct wired internet connection meeting the stated speed requirements, and maintain a quiet, secure, private workspace compliant with CVS Health and HIPAA guidelines. CVS Health provides computer equipment and related peripherals; the colleague provides workspace furniture. The role requires extended desk work and using multiple monitors and applications, digital communication and collaboration tools, secure systems, and basic technical troubleshooting.

Requirements

Active, unrestricted Nurse Practitioner license and ability to obtain and maintain multi-state licensure as required.
Current national board certification through ANCC, AANP, or another nationally recognized certifying body.
At least 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 meet work-from-home requirements, including a wired internet connection with minimum download and upload speeds, a quiet and secure private workspace, and working from the state and city of confirmed residence.
Ability to use multiple monitors and applications, digital communication and collaboration tools, and secure systems; perform basic technical troubleshooting; and learn new skills as the workplace 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.
Experience with Microsoft Office 365 applications, including Teams, Outlook, Word, Excel, and PowerPoint, or similar tools such as Google Workspace.

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 in 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 affect treatment initiation.
Promote a seamless provider experience through proactive communication and collaboration.
Identify trends, opportunities, and barriers affecting care access and provider experience.
Provide feedback on 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 focused on clinical quality and operational excellence.