Remote RN, Utilization Management & Care Coordination

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

Vantaggi offerti da questo lavoro

Comprehensive benefits

Descrizione del lavoro

CVS Health is seeking an experienced Registered Nurse (RN) to join our Utilization Management team, where you'll help ensure members receive the right care at the right time through evidence-based clinical review and care coordination.

You will review information, apply guidelines, collaborate with providers, and identify opportunities for care management referrals while supporting quality improvement initiatives.

Competenze

• Active, unrestricted RN license in your state of residence.
• 2+ years of RN experience in adult acute care or critical care.
• 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

Communication

Multitasking

Computer skills

Flexible schedule

Formazione

Associate Degree in Nursing

BSN preferred

Strumenti

Microsoft Office 365

EHR systems

Descrizione del lavoro

CVS Health is seeking an experienced Registered Nurse (RN) to join our Utilization Management team, where you'll help ensure members receive the right care at the right time through evidence-based clinical review and care coordination.

You will review information, apply guidelines, collaborate with providers, and identify opportunities for care management referrals while supporting quality improvement initiatives.