Remote RN Utilization Management Specialist

CVS Health; New Jersey; A distancia; USD 36.000 - 77.000; Jornada completa

Ventajas ofrecidas por este puesto de trabajo

Medical, dental, vision coverage

Paid time off

Retirement savings options

Wellness programs

Descripción de la vacante

CVS Health is seeking an experienced Registered Nurse to support utilization management and care coordination from a remote work setup within the United States. Candidates should have 2+ years of acute/critical care RN experience and an active RN license in their state of residence.

You will gather clinical information, apply guidelines, determine coverage, and collaborate with providers to optimize care and benefit utilization.

Formación

• Active Registered Nurse license in the state of residence
• 2+ years of RN experience in adult acute/critical care
• Available to work weekends, holidays, and evening hours as required by business needs
• Resides in EST time zone

Responsabilidades

• Assess, plan, implement, coordinate, monitor and evaluate options to facilitate healthcare services for members.
• Render coverage determinations/recommendations per guidelines and clinical judgment.
• Communicate with providers to coordinate care and identify referral opportunities.
• Promote quality and effective utilization of healthcare services and benefits.
• Consult with internal/external stakeholders in utilization/benefit management.

Conocimientos

Active RN license

Acute/critical care RN

Weekends/holidays availability

EST time zone resident

Educación

Associates Degree in Nursing

Bachelor's Degree in Nursing

Herramientas

Microsoft Office 365

EHR systems

VPN access

Descripción del empleo

CVS Health is seeking an experienced Registered Nurse to support utilization management and care coordination from a remote work setup within the United States. Candidates should have 2+ years of acute/critical care RN experience and an active RN license in their state of residence.

You will gather clinical information, apply guidelines, determine coverage, and collaborate with providers to optimize care and benefit utilization.