Remote RN - Utilization & Care Coordination

CVS Health; Oklahoma; Ibrido; USD 36.000 - 94.000; Tempo pieno

Vantaggi offerti da questo lavoro

Comprehensive benefits

Bonus eligibility

Work from home options

Descrizione del lavoro

CVS Health is seeking an experienced Registered Nurse (RN) for Utilization Management. The role focuses on evidence-based clinical review, care coordination, and ensuring members receive appropriate care at the right time.

You will review clinical data, apply guidelines, and collaborate with providers to improve patient outcomes within a dynamic, 24/7 environment. Strong communication and acute/critical care experience are essential.

Competenze

• Active, unrestricted RN license in your state of residence.
• 2+ years RN experience in an adult acute or critical care setting.
• Strong communication, multitasking, and computer navigation skills.
• Ability to work a flexible schedule, including evenings, weekends, and holidays as part of a 24/7 operation.
• Associates Degree in Nursing required.

Mansioni

• Review and assess clinical information to support coverage determinations and care recommendations.
• Apply clinical guidelines, policies, and professional judgment across the continuum of care.
• Collaborate with providers and healthcare teams to facilitate quality patient outcomes.
• Identify opportunities for care management referrals and member support programs.
• Promote effective healthcare utilization and quality improvement initiatives.

Conoscenze

RN license active

RN experience adult acute/critical

communication

multitasking

computer navigation

flexible schedule

Formazione

Associate Degree in Nursing

BSN preferred

Strumenti

EHR access

Descrizione del lavoro

CVS Health is seeking an experienced Registered Nurse (RN) for Utilization Management. The role focuses on evidence-based clinical review, care coordination, and ensuring members receive appropriate care at the right time.

You will review clinical data, apply guidelines, and collaborate with providers to improve patient outcomes within a dynamic, 24/7 environment. Strong communication and acute/critical care experience are essential.