Remote RN Utilization Management & Care Coordination

CVS Health; Des Moines (IA); On-site; USD 36,000 - 94,000; Full time

Benefits offered by this job

Medical, dental, vision coverage

Retirement savings options

Paid time off

Job summary

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

This full-time role requires an active RN license, 2+ years in acute or critical care, strong communication and computer skills, and a flexible schedule including evenings, weekends, and holidays. An Associates Degree in Nursing is required.

Qualifications

• Active, unrestricted RN license in your state of residence.
• 2+ years of RN experience in an adult acute care or critical care setting.
• Strong communication, multitasking, and computer navigation skills.
• Ability to work a flexible schedule, including evenings, weekends, and holidays as part of a 24/7 operation.
• Associates Degree in Nursing required.

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

RN licensure

2+ years RN experience

Communication skills

Flex schedule

Associates Degree in Nursing

Education

Associates Degree in Nursing

BSN preferred

Job description

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

This full-time role requires an active RN license, 2+ years in acute or critical care, strong communication and computer skills, and a flexible schedule including evenings, weekends, and holidays. An Associates Degree in Nursing is required.