Remote RN: Utilization Management & Care Coordination

CVS Health; Arizona; Hybrid; USD 36,000 - 94,000; Full time

Job summary

CVS Health is seeking an experienced Registered Nurse (RN) to join our Utilization Management team. You will help ensure members receive the right care at the right time through evidence-based clinical review and care coordination.

Active RN license and 2+ years of adult acute or critical care experience are required. The role supports a flexible schedule, including evenings, weekends, and holidays, in a remote-capable environment within the United States.

Qualifications

• Active, unrestricted RN license in the state of residence.
• 2+ years of RN experience in adult acute care or critical care.
• Strong communication, multitasking, and computer navigation skills.
• Ability to work a flexible schedule including evenings, weekends and holidays.

Responsibilities

• 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.

Skills

Communication

Multitasking

Computer literacy

Flexibility

Education

Associates Degree in Nursing

BSN preferred

Tools

Microsoft Office 365

Job description

CVS Health is seeking an experienced Registered Nurse (RN) to join our Utilization Management team. You will help ensure members receive the right care at the right time through evidence-based clinical review and care coordination.

Active RN license and 2+ years of adult acute or critical care experience are required. The role supports a flexible schedule, including evenings, weekends, and holidays, in a remote-capable environment within the United States.