Remote RN: Utilization Management & Care Coordination

4062 Aetna Resources, LLC; New York (NY); Ibrido; USD 91.704.000 - 196.258.000; Tempo pieno

Descrizione del lavoro

CVS Health is seeking a Registered Nurse (RN) to support 24/7 Utilization Management operations in a remote capacity. You will review cases, assess medical necessity, coordinate care, and ensure members receive high-quality healthcare services.

Requirements include an active RN license, 2+ years in adult acute/critical care, an ADN, and strong communication plus multitasking skills. Flexible schedule with weekend/evening hours may be needed.

Competenze

• Active, unrestricted RN license in your state of residence.
• 2+ years of RN experience in adult acute or critical care.
• Associate Degree in Nursing.
• Strong communication, multitasking, and computer navigation skills.
• Evening, weekend, and holiday shifts as needed.

Mansioni

• Review clinical information and apply evidence-based criteria for coverage and care.
• Collaborate with providers and care teams to coordinate treatment.
• Identify opportunities to improve quality and benefit utilization.
• Refer members to programs and services supporting health needs.
• Serve as a clinical resource for utilization and benefit management questions.

Conoscenze

Strong communication

Multitasking

Computer navigation

Formazione

Associate Degree in Nursing

BSN preferred

Descrizione del lavoro

CVS Health is seeking a Registered Nurse (RN) to support 24/7 Utilization Management operations in a remote capacity. You will review cases, assess medical necessity, coordinate care, and ensure members receive high-quality healthcare services.

Requirements include an active RN license, 2+ years in adult acute/critical care, an ADN, and strong communication plus multitasking skills. Flexible schedule with weekend/evening hours may be needed.