Remote RN: Utilization Management & Care Coordination

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

Vantaggi offerti da questo lavoro

Medical, dental, and vision coverage

Paid time off

Retirement savings options

Wellness programs

Descrizione del lavoro

CVS Health is seeking a Registered Nurse (RN) for Utilization Management to ensure members receive the right care at the right time through evidence-based reviews and care coordination. The role emphasizes collaboration with healthcare teams, clinical guidelines, and proactive care management.

The position supports a 24/7 operation with a flexible schedule, including evenings and holidays. Strong communication and data navigation skills are essential for success in a fast-paced, impactful

Competenze

• Active, unrestricted RN license in your state of residence.
• 2+ years of RN experience in an adult acute care or critical care setting.
• Associates Degree in Nursing required.
• Strong communication, multitasking, and computer navigation skills.

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 experience

Communication

Multitasking

Computer navigation

Formazione

Associates Degree in Nursing

Strumenti

Microsoft Office 365

Descrizione del lavoro

CVS Health is seeking a Registered Nurse (RN) for Utilization Management to ensure members receive the right care at the right time through evidence-based reviews and care coordination. The role emphasizes collaboration with healthcare teams, clinical guidelines, and proactive care management.

The position supports a 24/7 operation with a flexible schedule, including evenings and holidays. Strong communication and data navigation skills are essential for success in a fast-paced, impactful