Remote Utilization Management Nurse Consultant

CVS Health; Heber (UT); A distancia; USD 36.000 - 86.000; Jornada completa

Ventajas ofrecidas por este puesto de trabajo

Medical, dental, vision benefits

Paid time off

Retirement savings options

bonus program

Descripción de la vacante

CVS Health is seeking an Utilization Management Nurse Consultant to review clinical cases and make coverage determinations for Medicare beneficiaries. This remote, full-time role follows a weekday schedule, leveraging your RN expertise to ensure appropriate care and outcomes.

You will collaborate with care teams, coordinate treatment, and support utilization decisions while working within a 9:00 AM–6:00 PM time frame in your time zone. Benefits and ongoing professional growth are emphasized.

Formación

• Active, unrestricted RN license in the state of residence.
• 3+ years of RN experience, including 1+ year in Med/Surg
• Strong clinical assessment and decision-making skills
• Experience with Microsoft Office (Outlook, Teams, Excel)
• Ability to work Monday–Friday, 9:00 AM–6:00 PM in your time zone; Utilization Management is a 24/7 operation and schedules include holidays and evening hours
• Associate Degree in Nursing

Responsabilidades

• Review clinical cases and make coverage determinations using evidence-based guidelines
• Collaborate with providers and care teams to coordinate appropriate treatment
• Apply clinical judgment to support utilization and benefit management decisions
• Identify opportunities to improve care quality and member outcomes
• Serve as a clinical resource across internal and external stakeholders

Conocimientos

RN license

RN experience

Clinical assessment

MS Office

Work schedule

ADN

Educación

Associate Degree in Nursing

Herramientas

Microsoft Office 365

Descripción del empleo

CVS Health is seeking an Utilization Management Nurse Consultant to review clinical cases and make coverage determinations for Medicare beneficiaries. This remote, full-time role follows a weekday schedule, leveraging your RN expertise to ensure appropriate care and outcomes.

You will collaborate with care teams, coordinate treatment, and support utilization decisions while working within a 9:00 AM–6:00 PM time frame in your time zone. Benefits and ongoing professional growth are emphasized.