Remote RN: Utilization & Care Management Consultant

CVS Health Corporation; Hartford, Northern (CT, KY); Hybrid; USD 66,000 - 142,000; Full time

Benefits offered by this job

Comprehensive benefits package

Bonus eligibility

Job summary

CVS Health Corporation seeks a Registered Nurse to join the Utilization Management team. The role provides remote work in CT with Hartford base considerations, focusing on applying guidelines to determine appropriate care and coverage decisions.

You will collaborate with care teams, coordinate services, and support members across the continuum of care while contributing to quality outcomes and program alignment.

Qualifications

• Active, unrestricted RN license in state of residence.
• Minimum 2 years of RN experience in adult acute care or critical care.
• BSN preferred; strong clinical judgment and organizational skills.

Responsibilities

• Review clinical information and apply evidence-based guidelines to support coverage decisions.
• Collaborate with providers and care teams to coordinate services.
• Identify opportunities to improve care quality, outcomes, and utilization.
• Support members through the continuum of care and connect to programs.

Skills

RN license

Clinical judgment

Communication

Organizational skills

Education

Associate's Degree in Nursing

BSN preferred

Tools

Microsoft Office 365

Job description

CVS Health Corporation seeks a Registered Nurse to join the Utilization Management team. The role provides remote work in CT with Hartford base considerations, focusing on applying guidelines to determine appropriate care and coverage decisions.

You will collaborate with care teams, coordinate services, and support members across the continuum of care while contributing to quality outcomes and program alignment.