Remote Appeals Nurse Consultant

About the role

CVS Health is seeking a dedicated Appeals Nurse Consultant to join its remote team. In this full‑time position you will apply clinical judgment and regulatory knowledge to ensure fair and accurate resolution of clinical appeals.

Key responsibilities

• Review and resolve clinical appeals, including UM, MPO, coding, and behavioral health cases.
• Analyze documentation and clinical records to apply appropriate criteria and policies.
• Coordinate clinical resolution with internal and external clinician support.
• Work standard hours Monday‑Friday, 8:00 AM‑5:00 PM local time, with occasional weekend and holiday on‑call coverage.

Required profile

• Active, unrestricted RN licensure in the state of residence.
• Minimum of 3 years of clinical nursing experience.
• At least an Associate’s degree.
• Dedicated, interruption‑free home workspace; dependents must have separate care arrangements during work hours.

Required skills

• Proficiency with computer systems and ability to navigate multiple applications.

What we offer

• Competitive salary range $60,522 – $129,615 annually.
• Eligibility for bonus, commission or short‑term incentive programs.
• Comprehensive benefits package for full‑time employees.