Remote RN: Utilization Management & Care Coordination

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

Descrizione del lavoro

CVS Health in the United States seeks a Registered Nurse (RN) for Utilization Management to review coverage and guide care decisions across the continuum. This role emphasizes evidence-based review, care coordination, and collaboration with providers to improve patient outcomes.

The position is full-time and remote, with requirements for a flexible 24/7 schedule, strong clinical experience in adult acute/critical care, and proficiency with common office tools.

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.
• 2+ years of Med-Surg or specialty clinical experience.
• Managed Care and/or Utilization Management experience.
• Candidates residing in CST/MST/PST locations preferred.
• BSN preferred.

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

Flexibility

Associates degree

Formazione

Associates Degree in Nursing

BSN preferred

Strumenti

Microsoft Office 365

Google Workspace

Descrizione del lavoro

CVS Health in the United States seeks a Registered Nurse (RN) for Utilization Management to review coverage and guide care decisions across the continuum. This role emphasizes evidence-based review, care coordination, and collaboration with providers to improve patient outcomes.

The position is full-time and remote, with requirements for a flexible 24/7 schedule, strong clinical experience in adult acute/critical care, and proficiency with common office tools.