Remote Inpatient Utilization Nurse (RN)

4004 Aetna Medicaid Administrators; Louisiana (MO); Híbrido; USD 52.000 - 117.000; Jornada completa

Ventajas ofrecidas por este puesto de trabajo

Remote work

Medical, dental, vision coverage

Paid time off

Descripción de la vacante

CVS Health is seeking an experienced radi-? nurse for a 100% remote Concurrent Review RN position. The role supports inpatient reviews, discharge planning, and care transitions across the continuum.

Required is an active Louisiana RN license (or Compact), with 5+ years of inpatient nursing experience and strong clinical assessment. You must be willing to obtain additional state licensure and participate in weekend/holiday on-call rotations.

Formación

• Active RN license in Louisiana or Compact license.
• Willing to obtain additional state licensure as required.
• 5+ years of inpatient clinical nursing experience.
• Strong clinical assessment, critical-thinking, and communication skills.
• Willing to participate in rotating weekend and holiday on-call schedules.

Responsabilidades

• Conduct concurrent reviews for inpatient admissions and continued stays.
• Evaluate clinical documentation and determine medical necessity using guidelines.
• Collaborate with hospitals, physicians, utilization review, and care teams.
• Facilitate timely discharge planning and care transitions.
• Monitor inpatient treatment and identify opportunities to improve utilization and outcomes.
• Communicate recommendations and findings to providers and stakeholders.
• Support resource utilization while maintaining quality and compliance.

Conocimientos

RN license

Louisiana license

5+ years inpatient

Critical thinking

Communication skills

Weekend on-call

Educación

Associates Degree

Bachelor’s degree preferred

Descripción del empleo

CVS Health is seeking an experienced radi-? nurse for a 100% remote Concurrent Review RN position. The role supports inpatient reviews, discharge planning, and care transitions across the continuum.

Required is an active Louisiana RN license (or Compact), with 5+ years of inpatient nursing experience and strong clinical assessment. You must be willing to obtain additional state licensure and participate in weekend/holiday on-call rotations.