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At CVS Health, we’re building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care.As the nation’s leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues – caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day.Position SummaryUtilization Management is a 24/7 operation and work schedules will include weekends, holidays, and evening hours.<ul> <li>Utilizes clinical experience and skills in a collaborative process to assess, plan, implement, coordinate, monitor and evaluate options to facilitate appropriate healthcare services/benefits for members.</li> <li> Gathers clinical information and applies the appropriate clinical criteria/guideline, policy, procedure and clinical judgment to render coverage determination/recommendation along the continuum of care</li> <li>Communicates with providers and other parties to facilitate care/treatment Identifies members for referral opportunities to integrate with other products, services and/or programs</li> <li>Identifies opportunities to promote quality effectiveness of Healthcare Services and benefit utilization</li> <li>Consults and lends expertise to other internal and external constituents in the coordination and administration of the utilization/benefit management function.</li> <li>Typical office working environment with productivity and quality expectations.</li> <li>Work requires the ability to perform close inspection of hand written and computer generated documents as well as a PC monitor.</li> <li>Sedentary work involving periods of sitting, talking, listening.</li> <li>Work requires sitting for extended periods, talking on the telephone and typing on the computer. Ability to multitask, prioritize and effectively adapt to a fast paced changing environment.</li> <li>Position requires proficiency with computer skills which includes navigating multiple systems and keyboarding.</li> <li>Effective communication skills, both verbal and written</li> </ul>Required Qualifications - 2+ years of experience as a Registered Nurse in adult acute care/critical care setting - Must have active current and unrestricted RN licensure in state of residence- Utilization Management is a 24/7 operation and work schedules will include weekends, holidays, and evening hours Preferred Qualifications - 2+ years of clinical experience required in med surg or specialty area - Managed Care experience preferred, especially Utilization Management- Preference for those residing in ET, CT zones EducationAssociates Degree requiredBSN preferredAnticipated Weekly Hours40Time TypeFull timePay RangeThe typical pay range for this role is:$29.10 - $62.32This 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 peopleWe take pride in our comprehensive and competitive mix of pay and benefits – investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:<ul> <li>Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan.</li> <li>No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.</li> <li>Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.</li> </ul>For more information, visit <a href="https://jobs.cvshealth.com/us/en/benefits" target="_blank">https://jobs.cvshealth.com/us/en/benefits</a>We anticipate the application window for this opening will close on: 06/16/2025Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

CVSHealth

Utilization Management Nurse Consultant

Job Description: Merrill Wealth Management is a leading provider of comprehensive wealth management and investment products and services for individuals, companies, and institutions. Merrill Wealth Management is one of the largest businesses of its kind in the world specializing in goals-based wealth management, including planning for retirement, education, legacy, and other life goals through investment advice and guidance. Merrill’s Financial Advisors and Wealth Management Client Associates help clients pursue the life they envision through a personal relationship with their advisory team committed to their needs. We believe trust comes from transparency. Our trusted advisory teams are equipped with access to the investment insights of Merrill coupled with the banking convenience of Bank of America. At Merrill, we empower you to bring your whole self to work. We value diversity in our thoughts, business, and within our employees and clients. Our Wealth Management team represents an array of different backgrounds and bring their unique perspectives, ideas and experiences, helping to create a work community that is culture driven, resilient, results focused and effective. Job Description: This job is responsible for working with high-net worth clients with annual revenues of $100k-$5mm, identifying needs, developing relationships, reviewing investment goals, and preparing investment recommendations that align with the goals of both existing and prospective clients. Key responsibilities include leveraging technology to achieve business growth goals, profiling activities to determine a client's investor profile and financial resource objectives, building a sustainable book of business, and providing opportunities for advisors to pursue a career within the bank. This position is subject to SAFE Act registration requirements. Pursuant to the SAFE Act requirements, all employees engaged in residential loan mortgage originations must register with the federal registry system and remain in good standing. Since this position requires SAFE Act registration, employees are required to register and to submit to the required SAFE Act background check and registration process. Failure to obtain and/or maintain SAFE Act registration may result in disciplinary action up to and including termination. Responsibilities: <ul> <li>Provides tailored and personalized advice to clients through reviews and presentations, including assessing financial goals and recommending investment advisory strategies</li> <li>Communicates solutions to clients that are best suited for their financial needs, such as core Banking, and Investment and Life Priority™ solutions</li> <li>Partners with Financial Advisor teams to build their network by sharing relevant market developments and discussing new products (as appropriate) in an effort to promote portfolio growth</li> <li>Understands and accesses the full breadth of resources across the bank to benefit clients or prospects</li> <li>Develops and grows a book of business to meet and exceed pre-defined financial targets to measure their ability to progress to the next phase as an advisor</li> <li>Prioritizes client requests and makes introductions to appropriate internal service providers based on client needs and asset thresholds</li> </ul> The Advisor Development Program (ADP) Journey: During this stage of your journey, the Merrill Financial Solutions Advisor (MFSA) will help provide you with the necessary training and guidance through a defined path to become a successful and independent financial advisor. You will have the opportunity to work with both affluent and high net worth clients, identifying needs, developing relationships, reviewing investment goals, and preparing investment recommendations that align with the goals of both existing and prospective clients. In this role you will develop the relationship management skills necessary to operate in an Elite Growth Practice (EGP). From marketing yourself to managing your own practice, we’ll prepare you with everything you need as you develop within your role. The MFSA role provides experienced advisors the opportunity to pursue a career within Merrill Wealth Management. Once you have honed your skills and demonstrated success as a MFSA, you typically will progress into the next stage of training. Located in a Merrill branch. We’ll help you: <ul> <li>Get training and one-on-one mentorship from managers who are invested in your success. You’ll enroll in our Academy to develop as an advisor; the potential for growth is yours! </li> <li>Build connections to grow your network and business. Starting at a Merrill branch, you’ll interact with Merrill financial advisors, institutional retirement participants and higher net worth clients.</li> <li>Deliver advice through client reviews/presentations with confidence, including reviews of financial goals, and recommend investment advisory strategies to help clients achieve their financial goals.</li> <li>Learn about the full suite of financial solutions. Connect clients to solutions that are in their best interest, such as core Banking, Investment &amp; Life Priority™ solutions, through Bank of America and Merrill to meet their financial needs.</li> </ul> As a Merrill FSA, you can look forward to: <ul> <li>A strong referral network from across the business to increase opportunities for affluent and high net worth client acquisition and provide access to partners who are specialists in their field.</li> <li>Marketing strategies to reach wider audiences with greater appeal.</li> <li>Ongoing professional development to deepen your skills and optimize your practice as the industry evolves.</li> <li>Potential Opportunities for professional growth.</li> <li>Leadership opportunities, including leading client and conference seminars</li> </ul> We’re a culture that: <ul> <li>Is committed to building a workplace where every employee is welcomed and given the support and resources to build and advance their careers. Along with taking care of our clients, we want to be a great place for people to work, and we strive to create an environment where all employees have the opportunity to achieve their goals.</li> <li>Believes diversity makes us stronger so we can reflect, connect to and meet the diverse needs of our clients around the world.</li> <li>Provides continuous training and developmental opportunities to help employees achieve their goals, whatever their background or experience.</li> <li>Is committed to advancing our tools, technology and ways of working. We always put our clients first to meet their evolving needs.</li> <li>Believes in responsible growth and is dedicated to supporting communities around the world by connecting them to the lending, investing and giving they need to remain vibrant and vital.</li> </ul> Required Qualifications: <ul> <li>Currently holds Series 7 &amp; 66 (63 &amp; 65 in lieu of 66) licenses</li> <li>Two years' experience working in the financial service industry and/or a sales environment where goals were met or exceeded</li> <li>Minimum of one year experience in the investments industry, including investment training and in-depth knowledge of investment products and services</li> <li>Self-starter who efficiently manages time and capacity</li> <li>Sets and accomplishes goals, achieving whatever you put your mind to</li> <li>Builds and nurtures strong relationships</li> <li>Collaborates effectively with others to get things done</li> <li>Communicates effectively and confidently and is comfortable engaging all clients</li> <li>Manages goals, navigates complexity, prioritizes tasks and executes in a fast-paced environment</li> <li>Likes to learn, adapts to new information and seeks the right solutions for clients</li> <li>Thorough and thoughtful in incorporating relevant regulatory due diligence into daily activities and long-term strategies for clients</li> </ul> Desired Qualifications: <ul> <li>Proven ability to partner and promote lead generation</li> <li>Experience balancing investment management, sales activities, and new client development</li> <li>Strong computer skills and the ability to multitask in a demanding environment</li> <li>Bachelor's degree, preferably in business-related field</li> <li>Achieved additional professional designations such as Certified Financial Planner (CFP) and/or Chartered Retirement Planning Counselor (CRPC)</li> <li>Obtained insurance licenses ​</li> </ul> Skills: <ul> <li>Account Management</li> <li>Client Investments Management</li> <li>Client Management</li> <li>Client Solutions Advisory</li> <li>Relationship Building</li> <li>Advisory</li> <li>Business Development</li> <li>Fraud Management</li> <li>Pipeline Management</li> <li>Portfolio Management</li> <li>Client Experience Branding</li> <li>Issue Management</li> <li>Prospecting</li> <li>Referral Identification</li> <li>Sales Performance Management</li> </ul> Shift:1st shift (United States of America) Hours Per Week: 40

Bank of America

Merrill Financial Solutions Advisor - Sarasota/Naples Market

At CVS Health, we’re building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care.As the nation’s leading health solutions company, we reach millions of Americans through our local presence, digital channels and more than 300,000 purpose-driven colleagues – caring for people where, when and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it all with heart, each and every day.Position Summary CVS Health, a Fortune 6 company, has an outstanding opportunity for a Medical Director (Medical Affairs).This is a remote based, work from home opportunity. The Medical Affairs department provides clinical business support to the entire enterprise and provides clinical oversight and mentorship for CVS Health clinical programs, PBM Clinical Quality activities, consultative support to the P&amp;T process, formulary development, drug information services and pipeline activities, and provision of clinical leadership to various internal departments (e.g., specialty pharmacy services, clinical product development, Enterprise Analytics, Compliance, Legal, Accreditation) and clients. The Medical Director (Medical Affairs) will report into the Medical Affairs Department and is responsible for clinical support and consultative activities across the PBM. In this role you may provide consultative clinical support to Account Management in support of Key Clients as assigned. The Medical Director transacts Utilization Management UM activities (prior authorization and appeals) and responds to prescriber inquiries related to UM transactions and more generally related to CVS Health coverage policies. Medical Directors at CVS Health are encouraged to model the highest levels of clinical integrity, knowledge and cross functional thinking and decision making. Medical Directors represent the clinical decision making and professional thought process of the prescriber as a partner across the enterprise’s decisions and planning. – Each Director is responsible for providing oversight of a portion of CVS Health's clinical programs and commercial client program support. Will share in reviews of utilization management (PA) criteria and clinical policy revisions/reviews. – Directors will spend a portion of most days completing assigned medication utilization reviews (PA) and/or medical necessity appeals for commercial clients, governmental (Medicare/Medicaid) programs and individual client requested coverage determinations or appeals when appropriate. – Medical Directors will participate in inter-rater review activities and other quality oversight processes for internal Director UM decisions. If specifically assigned to one business segment (i.e., Medicare clients), each director will become sufficiently skilled in various UM programs to support other segments (including commercial and Medicaid) on evening and weekend coverage. –In this role you'll perform a share of special clinical investigations and research as requested by the Senior Medical Director, Medical Affairs. These projects can include brief reviews of published literature around specific pharmaceutical questions or more in-depth projects requiring collaboration with pharmacists within Medical Affairs and in business units outside of the Department. CVS Health, a Fortune 4 company, has an outstanding opportunity for a Medical Director (Medical Affairs). Required Qualifications * Family Medicine or Internal Medicine Board Certification.* Minimum of 5 years clinical experience in direct patient care. * 2 or more years proven experience in clinical outcomes, with a solid understanding of medical statistics, regulatory agencies, and analytic programs * Unrestricted license to practice medicine in the state in which the candidate is located. Preferred Qualifications * Combination of five years of management and/or clinical experience in a managed care environment and health administration, including adequate clinical experience in direct patient care and working with professionals at different levels as a teammate (e.g., RNs, PharmDs, etc.). * ABMS or AOA Board Certified in a recognized medical specialty, preferably in a Primary Care field (Internal medicine, Family Medicine) * Master’s Degree in Public Health Administration or MBA preferred, UM/QA certification desired * Proficiency in MS Office Suite Education * Must be graduate of an accredited Medical School and Residency Program * Possess an unrestricted active license to practice medicine in a State, Territory, Commonwealth of the United States, or the District of Columbia * Required annual Continuing Medical Education (CME) up to date and must remain current in medical and management areas during employmentPay RangeThe typical pay range for this role is:$174,070.00 - $374,920.00 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. This position also includes an award target in the company’s equity award program. 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 peopleWe take pride in our comprehensive and competitive mix of pay and benefits – investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:<ul> <li>Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan.</li> <li>No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.</li> <li>Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.</li> </ul>For more information, visit <a href="https://jobs.cvshealth.com/us/en/benefits" target="_blank">https://jobs.cvshealth.com/us/en/benefits</a>We anticipate the application window for this opening will close on: 06/30/2025Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

3 Jobs in Sarasota County