Remote Utilization Management Nurse Consultant

CVS Health; Pennsylvania; Híbrido; USD 40 000 - 86 000; Tempo integral

Vantagens oferecidas por esta oferta de emprego

Medical, dental, and vision coverage

Paid time off

Retirement savings options

Wellness programs

Resumo da oferta

CVS Health is seeking a qualified Registered Nurse for a remote Utilization Management role. You will assess and coordinate care, apply clinical criteria, and collaborate with providers to ensure appropriate services for members.

Responsibilities include reviewing cases, communicating with care teams, and promoting quality while meeting productivity standards. This full-time, work-from-home position offers comprehensive benefits.

Qualificações

• Registered Nurse with current RN licensure in the state of residence.
• 3+ years of RN experience; 1+ year in acute or post-acute settings.
• 1+ year in Utilization Management/Care Management.

Responsabilidades

• Gather clinical information and apply clinical criteria to render coverage determinations.
• Communicate with providers and other parties to facilitate care and referrals.
• Identify opportunities to promote quality and effectiveness of care.
• Consult and lend expertise to others in coordination and administration of UM/Care Management.
• Meet productivity and quality expectations as established by UMNC.

Conhecimentos

Verbal and written communication

Computer skills

Multitasking and prioritization

Extended sitting/phone use

Formação académica

RN diploma or better

Active RN license in state of residence

Descrição da oferta de emprego

CVS Health is seeking a qualified Registered Nurse for a remote Utilization Management role. You will assess and coordinate care, apply clinical criteria, and collaborate with providers to ensure appropriate services for members.

Responsibilities include reviewing cases, communicating with care teams, and promoting quality while meeting productivity standards. This full-time, work-from-home position offers comprehensive benefits.