Remote RN: Utilization Management Nurse Consultant

CVS Health; Louisiana; Teletrabalho; USD 36 000 - 86 000; Tempo integral

Vantagens oferecidas por esta oferta de emprego

Medical benefits

Dental benefits

Vision benefits

Paid time off

Retirement savings

Wellness programs

Other resources

Resumo da oferta

CVS Health is seeking a Medicare Precertification Utilization Management Nurse Consultant (RN) to support coverage determinations remotely. You will review clinical information, apply guidelines, collaborate with providers, and serve as a clinical resource within utilization management.

Training is Monday–Friday, then a 4‑day weekend schedule with 10‑hour shifts. The role requires an active RN license, 3+ years of RN experience, and MS Office proficiency.

Qualificações

• Active, unrestricted RN license in state of residence.
• 3+ years of RN experience.
• 1+ year Med/Surg experience.
• Proficiency with Microsoft Office (Outlook, Teams, Excel).
• Willingness to work required schedule post-training.

Responsabilidades

• Review and assess clinical information to support coverage determinations
• Apply clinical guidelines, policies, and sound judgment across the care continuum
• Collaborate with providers and care teams to coordinate treatment plans
• Identify opportunities to enhance quality, efficiency, and member outcomes
• Refer members to additional programs and services as appropriate
• Serve as a clinical resource within utilization/benefit management

Conhecimentos

Detail-oriented

Healthcare knowledge

Communication

Team collaboration

Formação académica

RN license (active, unrestricted)

BSN preferred; Associate’s required

Ferramentas

Microsoft Office 365

Descrição da oferta de emprego

CVS Health is seeking a Medicare Precertification Utilization Management Nurse Consultant (RN) to support coverage determinations remotely. You will review clinical information, apply guidelines, collaborate with providers, and serve as a clinical resource within utilization management.

Training is Monday–Friday, then a 4‑day weekend schedule with 10‑hour shifts. The role requires an active RN license, 3+ years of RN experience, and MS Office proficiency.