Remote RN: Utilization Management & Care Coordination

CVS Health; Annapolis (MD); Hybrid; USD 44,000 - 94,000; Full time

Benefits offered by this job

Medical, dental, vision coverage

Paid time off

Retirement savings options

Wellness programs

Job summary

CVS Health is seeking an experienced Registered Nurse (RN) to support Utilization Management, reviewing clinical information, applying evidence-based criteria, and coordinating care.

You will collaborate with providers, care teams, and internal partners to ensure timely, appropriate treatment and strong member outcomes.

This full-time, hybrid role offers flexible scheduling, remote work options within state guidelines, and a comprehensive benefits package.

Qualifications

• Active, unrestricted RN license in state of residence.
• 2+ years of RN experience in adult acute care or critical care settings.
• Strong clinical assessment, communication, and computer skills.
• Ability to thrive in a fast-paced, highly collaborative environment.
• Associates Degree in Nursing.

Responsibilities

• Review and assess clinical information to support utilization and coverage determinations.
• Collaborate with providers, care teams, and internal partners to facilitate appropriate treatment and care plans.
• Identify opportunities for care management referrals and member support programs.
• Promote quality, cost-effective healthcare outcomes.
• Serve as a clinical resource for utilization and benefit management activities.

Skills

RN license

2+ years RN

clinical assessment

communication

computer skills

Education

Associates Degree in Nursing

BSN (preferred)

Tools

Microsoft Office 365

EHR systems

Job description

CVS Health is seeking an experienced Registered Nurse (RN) to support Utilization Management, reviewing clinical information, applying evidence-based criteria, and coordinating care.

You will collaborate with providers, care teams, and internal partners to ensure timely, appropriate treatment and strong member outcomes.

This full-time, hybrid role offers flexible scheduling, remote work options within state guidelines, and a comprehensive benefits package.