Remote RN: Utilization & Care Coordination Consultant

CVS Health; East Windsor Hill (CT); Remote; USD 36,000 - 77,000; Full time

Benefits offered by this job

Medical coverage

Dental coverage

Vision coverage

Paid time off

Retirement savings options

Job summary

CVS Health is seeking an RN for utilization management, coordinating care and determining coverage for members. The role requires clinical judgment, strong communication with providers, and the ability to work in a fast-paced setting.

The position supports work-from-home requirements, with weekend/evening shifts as needed and adherence to CVS Health guidelines. Associates or Bachelors in Nursing preferred, located in EST zone.

Qualifications

• Active RN license in the home state required.
• At least 2 years of adult acute/critical care nursing experience.
• Ability to work weekends, holidays and evenings as needed.

Responsibilities

• Assess, plan, implement and coordinate care for members.
• Render coverage determinations using clinical guidelines and criteria.
• Communicate with providers to facilitate treatment decisions.
• Identify referral opportunities to integrate with other CVS programs.
• Maintain HIPAA-compliant documentation and processes.

Skills

RN license

Clinical nursing

Communication skills

MS Office / PC skills

Education

Associates Degree in Nursing

Bachelor's degree in Nursing (preferred)

Tools

EHR systems

VPN access

Job description

CVS Health is seeking an RN for utilization management, coordinating care and determining coverage for members. The role requires clinical judgment, strong communication with providers, and the ability to work in a fast-paced setting.

The position supports work-from-home requirements, with weekend/evening shifts as needed and adherence to CVS Health guidelines. Associates or Bachelors in Nursing preferred, located in EST zone.