Remote RN: Quality & Utilization Management Consultant

CVS Health; Tennessee; Remote; USD 36,000 - 77,000; Full time

Job summary

CVS Health is seeking a Registered Nurse for a remote/US-based role focused on utilization management and care coordination. The position requires clinical expertise, scheduling flexibility including weekends and evenings, and proficiency with multiple systems to assess and coordinate patient care.

The role emphasizes quality, HIPAA compliance, and collaborative problem-solving. The ideal candidate holds an Associate Degree in Nursing (Bachelor's preferred) and possesses strong communication

Qualifications

• Active and unrestricted RN license in their state of residence.
• 2+ years of RN experience in adult acute or critical care.
• Availability to work weekends, holidays, and evenings as required.

Responsibilities

• Assess, plan, implement, coordinate, monitor and evaluate healthcare services for members.
• Render coverage determinations/recommendations using clinical criteria and guidelines.
• Collaborate with providers and internal stakeholders to coordinate care and utilization management.

Skills

Clinical experience

Communication skills

Multitasking

Education

Associates Degree in Nursing

Bachelors Degree in Nursing

Job description

CVS Health is seeking a Registered Nurse for a remote/US-based role focused on utilization management and care coordination. The position requires clinical expertise, scheduling flexibility including weekends and evenings, and proficiency with multiple systems to assess and coordinate patient care.

The role emphasizes quality, HIPAA compliance, and collaborative problem-solving. The ideal candidate holds an Associate Degree in Nursing (Bachelor's preferred) and possesses strong communication