Remote RN: Utilization Management & Care Coordination

CVS Health; South Carolina; Hybrid; USD 36,000 - 103,000; Full time

Job summary

CVS Health is seeking an experienced Registered Nurse (RN) for Utilization Management. This full-time, remote role supports a 24/7 team, reviews cases, and coordinates care to improve outcomes within your state.

Requires active RN license, ADN, and 2+ years in adult acute/critical care, plus strong communication and computer skills. CVS Health offers a comprehensive benefits package and a mission-driven culture.

Qualifications

• Active, unrestricted RN license in your state of residence.
• 2+ years of RN experience in an adult acute care or critical care setting.
• Associate Degree in Nursing (ADN).
• Strong communication, multitasking, and computer skills.
• Ability to work a flexible schedule, including evenings, weekends, and holidays.

Responsibilities

• Review clinical information and apply evidence-based criteria to make coverage recommendations
• Collaborate with providers and interdisciplinary teams to support care coordination
• Identify opportunities to improve quality, outcomes, and healthcare resource utilization
• Refer members to appropriate programs and services that support their healthcare needs
• Serve as a clinical resource for internal and external stakeholders

Skills

RN license

Communication skills

Multitasking

Computer skills

Education

Associate Degree in Nursing (ADN)

Job description

CVS Health is seeking an experienced Registered Nurse (RN) for Utilization Management. This full-time, remote role supports a 24/7 team, reviews cases, and coordinates care to improve outcomes within your state.

Requires active RN license, ADN, and 2+ years in adult acute/critical care, plus strong communication and computer skills. CVS Health offers a comprehensive benefits package and a mission-driven culture.