Remote Utilization Management Nurse Consultant

CVS Health; Harrisburg (Dauphin County); On-site; USD 40,000 - 86,000; Full time

Benefits offered by this job

Medical, dental, and vision coverage

Paid time off

Retirement savings options

Wellness programs

Job summary

CVS Health is seeking an RN to join Utilization Management, a 24/7 operation including weekends, holidays and evenings. Typical schedule: Mon-Fri 08:00-05:00 PM EST.

You will assess and coordinate care, apply clinical criteria, render coverage determinations, and collaborate with providers to promote appropriate healthcare services and benefit utilization. Strong computer skills and HIPAA-compliant practice are required.

Qualifications

• RN with 2+ years of clinical experience in adult acute/critical care.
• Active, unrestricted RN licensure in state of residence.
• Associates Degree required; BSN preferred.

Responsibilities

• Gathers and applies clinical information to render coverage determinations.
• Collaborates with providers and teams to coordinate care and benefit utilization.
• Identifies referral opportunities and promotes quality healthcare services.

Skills

Clinical experience

RN experience

Communication skills

Education

Associates Degree

BSN preferred

Tools

EHR systems

Microsoft Office 365

Job description

CVS Health is seeking an RN to join Utilization Management, a 24/7 operation including weekends, holidays and evenings. Typical schedule: Mon-Fri 08:00-05:00 PM EST.

You will assess and coordinate care, apply clinical criteria, render coverage determinations, and collaborate with providers to promote appropriate healthcare services and benefit utilization. Strong computer skills and HIPAA-compliant practice are required.