Remote RN - Utilization Management & Care Coordination

CVS Health; Illinois; Ibrido; USD 36.000 - 94.000; Tempo pieno

Descrizione del lavoro

CVS Health is seeking a Registered Nurse (RN) for Utilization Management. The role focuses on ensuring members receive appropriate care through evidence-based review and care coordination. The position targets candidates with strong clinical judgment and readiness to work in a 24/7 environment.

Ideal candidates hold an active RN license and an associate degree in nursing. 2+ years of acute or critical care experience is preferred, with BSN as a plus.

Competenze

• Active, unrestricted RN license in your state of residence.
• 2+ years RN experience in adult acute care or critical care.
• Strong communication, multitasking, and computer navigation skills.
• Associates Degree in Nursing required.

Mansioni

• 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.

Conoscenze

Communication skills

Computer navigation

Flexibility with schedule

Formazione

Associates Degree in Nursing

BSN preferred

Strumenti

Microsoft Office 365

Descrizione del lavoro

CVS Health is seeking a Registered Nurse (RN) for Utilization Management. The role focuses on ensuring members receive appropriate care through evidence-based review and care coordination. The position targets candidates with strong clinical judgment and readiness to work in a 24/7 environment.

Ideal candidates hold an active RN license and an associate degree in nursing. 2+ years of acute or critical care experience is preferred, with BSN as a plus.