Remote RN Quality & Utilization Consultant

CVS Health; Fulton (MS); Remote; USD 36,000 - 77,000; Full time

Job summary

CVS Health is seeking a Registered Nurse to join our Utilization Management team in a remote, full-time role. You will assess and coordinate care, review clinical information and render coverage recommendations while collaborating with providers and internal stakeholders.

Candidates must hold an active RN license, have 2+ years in adult acute/critical care, and be able to work weekends and evenings as required. AAS in Nursing is required; BSN preferred.

Qualifications

• Active RN license in the state of residence.
• 2+ years of RN experience in adult acute/critical care.
• Ability to work weekends, holidays and evenings as required.

Responsibilities

• Assess, plan, implement, coordinate, monitor and evaluate options to facilitate healthcare services for members.
• Render coverage determination/recommendation along the continuum of care.
• Communicate with providers to facilitate care/treatment and coordinate with internal teams.
• Identify referral opportunities to integrate with other CVS Health products and programs.

Skills

RN license

Clinical nursing experience

Communication skills

Flexible schedule

Education

Associates Degree in Nursing

Bachelor's Degree in Nursing

Tools

Microsoft Office 365

Teams

Outlook

Excel

Word

PowerPoint

Google Workspace

Job description

CVS Health is seeking a Registered Nurse to join our Utilization Management team in a remote, full-time role. You will assess and coordinate care, review clinical information and render coverage recommendations while collaborating with providers and internal stakeholders.

Candidates must hold an active RN license, have 2+ years in adult acute/critical care, and be able to work weekends and evenings as required. AAS in Nursing is required; BSN preferred.