Remote RN: Utilization Management Specialist

African American Talent; Arizona; Remote; USD 36,000 - 94,000; Full time

Benefits offered by this job

Medical coverage

Dental coverage

Vision coverage

Paid time off

Retirement savings options

Wellness programs

Job summary

CVS Health is hiring a Registered Nurse (RN) for Utilization Management to assess and coordinate care, ensuring appropriate utilization and outcomes. You’ll work with providers and care teams to apply guidelines and support member care decisions.

The role requires an active RN license, 2+ years acute/critical care, and flexibility for a 24/7 operation. This remote, full-time position offers a comprehensive benefits package and opportunities to impact patient care across communities.

Qualifications

• Active, unrestricted RN license in your state of residence.
• 2+ years of RN experience in an adult acute care or critical care setting.
• Strong communication, multitasking, and computer navigation skills.
• Ability to work a flexible schedule, including evenings, weekends, and holidays as part of a 24/7 operation.
• Associates Degree in Nursing required.

Responsibilities

• 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.

Skills

RN license

2+ years experience

Communication

Multitasking

Computer navigation

Flexible schedule

Education

Associates Degree in Nursing

BSN preferred

Tools

EHR systems

Microsoft Office 365

Job description

CVS Health is hiring a Registered Nurse (RN) for Utilization Management to assess and coordinate care, ensuring appropriate utilization and outcomes. You’ll work with providers and care teams to apply guidelines and support member care decisions.

The role requires an active RN license, 2+ years acute/critical care, and flexibility for a 24/7 operation. This remote, full-time position offers a comprehensive benefits package and opportunities to impact patient care across communities.