Cvs Prior Authorization Jobs in Virginia (NOW HIRING)

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Title: Registered Nurse

Company: Oak Street Health

Role Description:

The Center Nurse is a clinical care team member operating within a Value-Based Care model, which prioritizes patient health outcomes and long-term wellness. In this model, the Center Nurse supports the health of patients by utilizing standards, guidelines and pathways for care delivery to prevent complications before they occur. Our Center Nurses drive quality care through clinical assessments, chronic condition management, and collaborating with the care team to reduce avoidable hospitalizations. You will foster an engaging and welcoming environment through effective team communication and delegation, empowering everyone on the team to deliver the best care to our patients.

Our Center Nurses report to the Practice Manager.

Core Responsibilities:

• Support patient assessment and prioritization for both walk-in and telephonic triage to ensure patients receive the right level of care and avoid unnecessary hospital visits.

• Execute protocol-driven chronic condition management.

• Perform skilled nursing procedures including wound care and medication administration (including vaccines).

• Provide comprehensive patient and caregiver education regarding chronic conditions and preventative care in person, over the phone, or in group settings.

• Conduct medication reviews within nurse-led visits to ensure patient safety and adherence.

• Conduct onsite testing (including point-of-care labs, EKGs, and specimen collection) and use patient data to identify and close gaps in preventative screenings, ensuring compliance with state scope of practice.

• Review and act upon high-priority abnormal laboratory results in a timely manner to maintain patient safety and continuity of care.

• Partner with providers and the interdisciplinary team to manage complex care plans and coordinate weekly transitions for patients moving from the hospital back to the clinic.

• Utilize standardized protocols for medication management, prescription renewals and prior authorizations.

• Ensures clinical communications are managed, tasks are completed and patient visit encounters are closed in a timely manner.

• Delegates to medical assistants and phlebotomists as needed to support patient flow and efficiency.

• Performs other related duties as assigned.

Clinical Responsibilities:

• Supports the coordination, integration, communication, and implementation of nursing practice and standard operating procedures.

• Identifies barriers to optimal care, e.g. physical, cognitive, language, literacy, socioeconomic, cultural, and or behavioral.

• Create a welcoming and engaging environment to meet the needs of our patients, communities, families and teams where they are.

• Deliver an exceptional patient experience through service, responsiveness and respectful care.

• Serve as a key clinical voice in daily care team meetings to align on patient priorities and clinic operations.

• Serves as a support and resource for nursing, other clinical staff and providers.

• Ensures clinical compliance with Patient Safety initiatives and reporting.

• Provides emergency care in accordance with organizational procedure.

Professional Responsibilities:

• Engages in self-evaluation and participates in activities to promote own professional growth and development.

• Seeks, acquires and maintains current nursing knowledge and competence to fulfill responsibilities as a Center Nurse.

• Maintains awareness of current patient centered, evidence-based practice and considers applicable research data to patient care delivery.

• Fulfills obligation to identify and report professional misconduct appropriately.

What we're looking for

Required Qualifications:

• Active, Unrestricted Registered Nurse Licensure in the state that you reside

• BLS or CPR Certification

• Fluent written and spoken English language skills.

• US work authorization

• Electronic Medical Record (EMR) experience

• Ability to maintain patient confidentiality and process information in a confidential manner

• Ability to assess patients without face-to face interaction, strong communication and assessment skill

Strongly Preferred Qualifications:

• Ability to collaborate and communicate with members of an interdisciplinary care team

• Excellent computer skills with ability to read, interpret and analyze data from various computer systems

• Effective problem solving and prioritization skills

• 2+ years of healthcare experience, working as an RN

Preferred Qualifications:

• Previous experience in clinic setting

• Ability to work independently

• Fluency in Spanish, Polish, Russian, or other languages spoken by people in the communities we serve

Anticipated Weekly Hours

40

Time Type

Full time

Pay Range

The typical pay range for this role is:

$60,522.00 - $129,615.00

This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above.

Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.

Great benefits for great people

We take pride in offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families.

This full-time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial well-being of colleagues and their families. The benefits for this position include medical, dental, and vision coverage, paid time off, retirement savings options, wellness programs, and other resources, based on eligibility.

Additional details about available benefits are provided during the application process and on Benefits Moments (https://learn.bswift.com/cvshealth-mainland) .

We anticipate the application window for this opening will close on: 01/28/2027

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

CVS Health is an equal opportunity/affirmative action employer, including Disability/Protected Veteran - committed to diversity in the workplace.