Remote RN: Utilization Management Specialist

CVS Health; Indianapolis (IN); À distance; USD 36 000 - 77 000; Plein temps

Avantages offerts par ce poste

Medical coverage

Dental coverage

Vision coverage

Paid time off

Résumé du poste

CVS Health is seeking an experienced Registered Nurse to join our Utilization Management team in a remote, work-from-home capacity. You will review clinical documentation, apply evidence‑based criteria, and coordinate services to ensure appropriate, high‑quality, and cost-effective care.

Ideal candidates have an active RN license, 2+ years in adult acute or critical care, and strong assessment and communication skills.

Qualifications

• Active, unrestricted RN license in your state of residence.
• 2+ years of adult acute care and/or critical care nursing experience.
• Strong clinical assessment, critical thinking, and communication skills.
• Ability to manage multiple priorities in a fast-paced, technology-driven environment.
• Proficiency navigating multiple computer systems.
• Associate Degree in Nursing required.

Responsabilités

• Review clinical documentation and apply evidence-based criteria to support coverage determinations.
• Assess, coordinate, monitor, and evaluate healthcare services across the continuum of care.
• Collaborate with providers and care teams to facilitate treatment plans and care coordination.
• Identify opportunities to improve healthcare quality, effectiveness, and benefit utilization.
• Connect members to additional programs and resources that support positive health outcomes.
• Serve as a clinical resource and consultant to internal and external stakeholders.

Connaissances

Clinical assessment

Critical thinking

Communication

Prioritization

Team collaboration

Formation

Associate Degree in Nursing

Outils

Microsoft Office 365

EHR systems

Secure remote access (VPN)

Description du poste

CVS Health is seeking an experienced Registered Nurse to join our Utilization Management team in a remote, work-from-home capacity. You will review clinical documentation, apply evidence‑based criteria, and coordinate services to ensure appropriate, high‑quality, and cost-effective care.

Ideal candidates have an active RN license, 2+ years in adult acute or critical care, and strong assessment and communication skills.