Remote RN: Utilization Management & Care Coordination

CVS Health; Harrisburg (Dauphin County); Remote; USD 40,000 - 85,000; Full time

Benefits offered by this job

Remote opportunity

Equipment provided

Comprehensive benefits

Job summary

CVS Health in the United States is seeking an experienced Registered Nurse to join our Utilization Management team in a fully remote role. You will review clinical information, coordinate care, and help ensure members receive appropriate services while supporting a 24/7 operation.

This role requires an active RN license, 2+ years in adult acute/clinical settings, and the ability to work independently from home. We offer comprehensive benefits and the technology tools needed to succeed.

Qualifications

• Active, unrestricted RN license in your state.
• 2+ years of RN experience in adult acute care, critical care, or medical-surgical.
• Strong clinical judgment, communication, and multitasking skills.
• Comfort navigating multiple computer systems, monitors, and Microsoft Office applications.
• Ability to work independently in a remote environment.
• Associates degree in nursing required – BSN Preferred.

Responsibilities

• Review clinical information and apply guidelines to make coverage decisions.
• Coordinate with providers and care teams to support treatment plans.
• Identify opportunities for care management referrals and improved utilization.
• Promote quality, efficiency, and positive member outcomes.
• Work in a fast-paced, technology-driven environment while meeting productivity and quality goals.

Skills

RN license

Clinical judgement

Communication

Multitasking

Independent work

Computer literacy

Education

Associates degree in nursing

BSN preferred

Tools

Microsoft Office

Job description

CVS Health in the United States is seeking an experienced Registered Nurse to join our Utilization Management team in a fully remote role. You will review clinical information, coordinate care, and help ensure members receive appropriate services while supporting a 24/7 operation.

This role requires an active RN license, 2+ years in adult acute/clinical settings, and the ability to work independently from home. We offer comprehensive benefits and the technology tools needed to succeed.