Clinical Nurse Utilization Consultant

4062 Aetna Resources, LLC; New Jersey; Hybrid; USD 44,000 - 94,000; Full time

Benefits offered by this job

Medical, dental, vision

Paid time off

Retirement savings

Wellness programs

Job summary

CVS Health is seeking a Registered Nurse for Utilization Management in a 24/7 operation. The role assesses, plans, coordinates, and evaluates options to ensure appropriate healthcare services and benefits for members, communicating with providers to facilitate care.

The position requires 2+ years RN in adult acute/critical care, active RN license, and willingness to work weekends, holidays, and evenings. This remote, full-time role demands strong computer literacy and the ability to navigate

Qualifications

• 2+ years of experience as a Registered Nurse in adult acute care/critical care setting.
• 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.

Responsibilities

• Assess, plan, implement, coordinate, monitor and evaluate options to facilitate appropriate healthcare services/benefits for members.
• Communicate with providers and other parties to facilitate care/treatment.
• Identify members for referral opportunities to integrate with other products, services and/or programs.
• Consult and lend expertise to internal and external constituents in utilization/benefit management.

Skills

Registered Nurse experience

RN licensure

Flexible schedule

Education

Associates Degree

BSN preferred

Tools

Microsoft Office 365

EHR systems

Job description

CVS Health is seeking a Registered Nurse for Utilization Management in a 24/7 operation. The role assesses, plans, coordinates, and evaluates options to ensure appropriate healthcare services and benefits for members, communicating with providers to facilitate care.

The position requires 2+ years RN in adult acute/critical care, active RN license, and willingness to work weekends, holidays, and evenings. This remote, full-time role demands strong computer literacy and the ability to navigate