Remote RN: Utilization & Care Coordination

CVS Health Corporation; Topeka (KS); Hybrid; USD 36,000 - 77,000; Full time

Job summary

CVS Health Corporation is seeking an experienced Registered Nurse to join our Utilization Management team in a remote capacity. You will review clinical information and apply guidelines to support coverage decisions and collaborate with care teams for effective treatment planning.

The role requires 2+ years of adult acute/critical care nursing, strong clinical assessment, and proficiency with multiple computer systems. Remote work with CST preference and 24/7 operations.

Qualifications

• Active, unrestricted RN license in your state of residence.
• 2+ years of adult acute care and/or critical care nursing experience.
• Strong clinical assessment and decision-making abilities.
• Ability to multitask and work in a fast-paced environment.
• Proficiency with multiple computer systems and applications.
• Associate Degree in Nursing required.

Responsibilities

• Review clinical information and apply guidelines to support coverage determinations.
• Assess, coordinate, monitor, and evaluate care across the continuum.
• Collaborate with providers and care teams to plan appropriate treatment.
• Identify opportunities to improve quality of care and member outcomes.
• Connect members with programs and resources when appropriate.
• Serve as a clinical resource for stakeholders.

Skills

RN license

Critical thinking

Communication skills

Multitasking

Computer systems proficiency

Education

Associate Degree in Nursing

Tools

EHR systems

Microsoft Office 365

Job description

CVS Health Corporation is seeking an experienced Registered Nurse to join our Utilization Management team in a remote capacity. You will review clinical information and apply guidelines to support coverage decisions and collaborate with care teams for effective treatment planning.

The role requires 2+ years of adult acute/critical care nursing, strong clinical assessment, and proficiency with multiple computer systems. Remote work with CST preference and 24/7 operations.