Remote Utilization Management Nurse Consultant

CVS Health; Louisiana; À distance; USD 36 000 - 77 000; Plein temps

Avantages offerts par ce poste

Medical insurance

Dental insurance

Vision coverage

Paid time off

Retirement savings

Résumé du poste

CVS Health is seeking a Registered Nurse to assess, plan, implement, coordinate and evaluate healthcare services for members. You will apply clinical criteria and collaborate with providers to support care decisions and referral opportunities while maintaining high-quality utilization management practices.

The role requires an active RN license, 2+ years of acute/critical care experience, and flexibility to work weekends and evenings.

Qualifications

• Active and unrestricted RN license in their state of residence.
• 2+ years of RN experience in adult acute/critical care.
• Ability to work weekends, holidays, and evenings as required by business needs.
• Experience with EMR and multiple clinical systems.

Responsabilités

• Assess, plan, implement, coordinate, monitor and evaluate options to facilitate healthcare services for members.
• Render coverage determinations using clinical guidelines and judgment.
• Communicate with providers to facilitate care and identify referral opportunities.
• Promote quality and appropriate utilization of healthcare services.
• Consult with internal/external stakeholders in utilization management.
• Perform in a sedentary office environment with computer-based tasks and multitasking capabilities.

Connaissances

Clinical assessment

Communication skills

Collaboration

Formation

Associates Degree in Nursing

Bachelor's Degree in Nursing

Outils

Microsoft Office 365

Description du poste

CVS Health is seeking a Registered Nurse to assess, plan, implement, coordinate and evaluate healthcare services for members. You will apply clinical criteria and collaborate with providers to support care decisions and referral opportunities while maintaining high-quality utilization management practices.

The role requires an active RN license, 2+ years of acute/critical care experience, and flexibility to work weekends and evenings.