Remote RN: Utilization Management Consultant (Weekend)

CVS Health; North Carolina; Hybrid; USD 36,000 - 94,000; Full time

Benefits offered by this job

Bonus eligibility

Comprehensive benefits package

Paid time off

Job summary

CVS Health is seeking a Registered Nurse to join our Utilization Management team in a work-from-home weekend position. You will assess, plan, and coordinate care, applying clinical criteria to determine appropriate benefits and services for members.

The role requires 3+ years RN experience, 1+ year in UM/Care Management, and active RN licensure. You will collaborate with providers, monitor outcomes, and ensure high-quality, cost-effective care while meeting productivity standards in a fast-paced

Qualifications

• Active RN license in state of residence.
• ≥3 years of RN experience.
• ≥1 year in Utilization Management / Care Management.
• May require additional nursing licenses as needed.

Responsibilities

• Render coverage determinations and recommendations along the care continuum.
• Communicate with providers and other parties to facilitate care.
• Identify referral opportunities to integrate with products, services, or benefits.
• Promote quality and effectiveness of healthcare services and utilization.
• Meet productivity and quality expectations per UMNC.

Skills

Communication skills

Computer skills

Multitasking

Endurance (sitting)

Education

RN Diploma or degree

BSN/Associates preferred

Job description

CVS Health is seeking a Registered Nurse to join our Utilization Management team in a work-from-home weekend position. You will assess, plan, and coordinate care, applying clinical criteria to determine appropriate benefits and services for members.

The role requires 3+ years RN experience, 1+ year in UM/Care Management, and active RN licensure. You will collaborate with providers, monitor outcomes, and ensure high-quality, cost-effective care while meeting productivity standards in a fast-paced