Remote Utilization Management Nurse Consultant

CVS Health; Florida; Híbrido; USD 36.000 - 103.000; Jornada completa

Ventajas ofrecidas por este puesto de trabajo

Medical, Dental, Vision

Paid time off

Retirement savings

Wellness programs

Descripción de la vacante

CVS Health is seeking an experienced Utilization Management RN to support coverage determinations from a remote location in the United States. You will apply clinical criteria across the care continuum and collaborate with providers to improve member outcomes.

The role requires an active RN license, at least 2 years of adult acute/critical care experience, and an Associate’s degree in nursing. Preference for candidates in Eastern Time Zone; BSN is a plus.

Formación

• Active, unrestricted RN license in your state of residence.
• Minimum 2 years of RN experience in an adult acute care or critical care setting.
• Associates degree in nursing.

Responsabilidades

• Review and assess clinical information to support coverage determinations and recommendations.
• Apply evidence-based clinical criteria, policies, and professional judgment across the continuum of care.
• Collaborate with providers and interdisciplinary teams to coordinate care and promote positive member outcomes.
• Identify opportunities for quality improvement, care integration, and effective benefit utilization.
• Serve as a clinical resource for internal and external stakeholders.

Conocimientos

RN license

2+ years RN

Associates degree

Educación

Associate's degree in nursing

Descripción del empleo

CVS Health is seeking an experienced Utilization Management RN to support coverage determinations from a remote location in the United States. You will apply clinical criteria across the care continuum and collaborate with providers to improve member outcomes.

The role requires an active RN license, at least 2 years of adult acute/critical care experience, and an Associate’s degree in nursing. Preference for candidates in Eastern Time Zone; BSN is a plus.