Remote Utilization Management Nurse Consultant

Pennsylvania Psychological Association; Phoenix (AZ); Remote; USD 40,000 - 85,000; Full time

Benefits offered by this job

Medical benefits

Dental benefits

Vision benefits

Paid time off

Retirement plan

Wellness programs

Job summary

CVS Health is hiring a Nurse Consultant for a 100% remote Utilization Management role. You will apply clinical judgment to review inpatient and outpatient services, authorize care, and collaborate with providers while maintaining precise documentation.

The position requires an active RN license, 3+ years in behavioral health, and a mandatory 3-week training with full participation. The role includes occasional on-call rotational coverage and the potential to work flexible hours to meet URAC and

Qualifications

• Active RN license in the state of residence is required.
• 3+ years of acute behavioral health or substance abuse clinical nursing experience.
• 1+ year of concurrent review or prior authorization, preferably in Behavioral Health and Substance Abuse.
• Must attend a mandatory 3-week training with 100% participation.

Responsibilities

• Review inpatient and outpatient services using evidence-based criteria to authorize care.
• Collaborate with providers and elevate cases as needed.
• Maintain accurate documentation while navigating multiple systems and performing computer-based work.
• Support on-call rotational coverage on weekends and some holiday shifts as required by URAC and client requirements.

Skills

Nursing

Behavioral Health

Clinical Review

Training Compliance

Education

Associate's degree in nursing (RN)

Tools

EHR systems

Job description

CVS Health is hiring a Nurse Consultant for a 100% remote Utilization Management role. You will apply clinical judgment to review inpatient and outpatient services, authorize care, and collaborate with providers while maintaining precise documentation.

The position requires an active RN license, 3+ years in behavioral health, and a mandatory 3-week training with full participation. The role includes occasional on-call rotational coverage and the potential to work flexible hours to meet URAC and