Remote RN: Utilization Management & Care Coordination

CVS Health; Indiana; Ibrido; USD 36.000 - 95.000; Tempo pieno

Descrizione del lavoro

CVS Health is seeking a Registered Nurse (RN) for Utilization Management to help ensure members receive appropriate care through evidence-based clinical review and care coordination. This full-time role supports a 24/7 operation and requires an active RN license and at least 2 years of relevant experience.

The position emphasizes collaboration with providers, applying guidelines, and promoting quality outcomes while offering a comprehensive benefits package.

Competenze

• 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.

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

RN license

RN experience

Communication

Flexible schedule

Formazione

Associates Degree in Nursing

BSN preferred

Strumenti

Microsoft Office 365 (Teams, Outlook, Word, Excel, PowerPoint)

Descrizione del lavoro

CVS Health is seeking a Registered Nurse (RN) for Utilization Management to help ensure members receive appropriate care through evidence-based clinical review and care coordination. This full-time role supports a 24/7 operation and requires an active RN license and at least 2 years of relevant experience.

The position emphasizes collaboration with providers, applying guidelines, and promoting quality outcomes while offering a comprehensive benefits package.