Quality Management Nurse Associate LPN

CVS Health • Austin, TX

414d • $46,592 - $121,472 • Remote

About The Position

The Quality Management Nurse Associate LPN at CVS Health is responsible for reviewing and approving pre-service post-acute denial correspondence. This role involves collaboration with RNs and Medical Directors to ensure that denial letters meet CMS requirements while maintaining member-friendly language. The position is fully remote and operates on a Monday to Friday schedule from 11 am to 7 pm EST.

Requirements

• Active current and unrestricted LPN/LVN licensure in state of residence.
• 3+ years of clinical experience.
• 3+ years of experience using personal computer and MS Office Suite applications.
• 1+ year of Medicare experience.

Nice To Haves

• Managed care experience
• Leadership experience
• Utilization Management, Precertification or Quality Management experience.

Responsibilities

• Review and approve pre-service post-acute denial correspondence.
• Collaborate with RNs and Medical Directors on denial letter language.
• Ensure compliance with CMS requirements for denial letters.
• Identify needs for standard denial language and suggest options to close gaps.

Benefits

• Medical, dental, and vision benefits
• 401(k) retirement savings plan
• Employee Stock Purchase Plan
• Fully-paid term life insurance
• Short-term and long-term disability benefits
• Well-being programs
• Education assistance
• Free development courses
• CVS store discount
• Paid Time Off (PTO)
• Paid holidays

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Industry: Health and Personal Care Retailers
• Education Level: High school or GED