Remote Nurse Consultant - Utilization & Care Coordination

IntelliResume; Town of Texas (WI); Teletrabalho; USD 36 000 - 95 000; Tempo integral

Vantagens oferecidas por esta oferta de emprego

Medical, dental, and vision coverage

Paid time off

Retirement savings options

Wellness programs

Resumo da oferta

CVS Health is seeking an RN Nurse Consultant for a remote role focused on utilization management and benefit coordination. The position emphasizes evidence-based decision making and collaboration with providers to ensure appropriate patient care.

The role requires an active RN license, a nursing degree, and at least two years of acute hospital RN experience, with preference for medical-surgical or ICU backgrounds. This is a full-time, remote opportunity with regular daytime hours.

Qualificações

• RN license active and unrestricted in their state of residence.
• 2+ years of acute hospital RN experience (medical-surgical/ICU preferred).
• BSN preferred; Associate Degree in Nursing required.

Responsabilidades

• Drive effective utilization management practices for healthcare resources.
• Conduct routine utilization reviews and assessments using evidence-based criteria.
• Collaborate with healthcare providers to develop and implement care plans.
• Review and analyze medical records for compliance with guidelines.
• Consult with internal and external constituents on utilization management.
• Communicate with stakeholders to facilitate care coordination.
• Provide coaching and guidance to nursing staff on utilization management.
• Contribute to the development of utilization management strategies and policies.
• Gather clinical information to render coverage determinations.
• Identify members for referral opportunities to integrate with other services.

Conhecimentos

Utilization management

Care coordination

Evidence-based criteria

Clinical documentation

Formação académica

Associate Degree in Nursing

BSN preferred

Descrição da oferta de emprego

CVS Health is seeking an RN Nurse Consultant for a remote role focused on utilization management and benefit coordination. The position emphasizes evidence-based decision making and collaboration with providers to ensure appropriate patient care.

The role requires an active RN license, a nursing degree, and at least two years of acute hospital RN experience, with preference for medical-surgical or ICU backgrounds. This is a full-time, remote opportunity with regular daytime hours.