Quality & Utilization RN Consultant (Remote)

CVS Health; Minneota (MN); A distancia; USD 36.000 - 77.000; Jornada completa

Ventajas ofrecidas por este puesto de trabajo

Medical benefits

Paid time off

Retirement options

Descripción de la vacante

CVS Health is seeking a Registered Nurse to join its Utilization Management team in Minnesota. This full-time role requires clinical expertise to assess, plan, implement, coordinate, monitor and evaluate care and benefits for members, with emphasis on evidence-based criteria and HIPAA compliance.

Responsibilities include communicating with providers, guiding coverage decisions, identifying referral opportunities and contributing to quality improvement initiatives.

Formación

• Active RN license in state of residence.
• Associates Degree in Nursing required; Bachelor’s preferred.
• 2+ years of RN experience in adult acute/critical care.

Responsabilidades

• Assess, plan, implement, coordinate, monitor and evaluate care and benefits.
• Render coverage determinations using clinical criteria and guidelines.
• Communicate with providers to facilitate care and treatment.
• Identify referral opportunities to integrate services and programs.
• Support quality and utilization management initiatives.

Conocimientos

Clinical nursing

Communication skills

Multitasking

Educación

Associates Degree in Nursing

Bachelor's Degree in Nursing

Descripción del empleo

CVS Health is seeking a Registered Nurse to join its Utilization Management team in Minnesota. This full-time role requires clinical expertise to assess, plan, implement, coordinate, monitor and evaluate care and benefits for members, with emphasis on evidence-based criteria and HIPAA compliance.

Responsibilities include communicating with providers, guiding coverage decisions, identifying referral opportunities and contributing to quality improvement initiatives.