Remote Utilization Management Nurse Consultant (RN)

CVS Health Corporation; United States; Remote; USD 40,000 - 85,000; Full time

Job summary

CVS Health Corporation is seeking a Remote UM Nurse Consultant RN Precertification for Telework. This role involves reviewing clinical information, collaborating with providers, and approving or referring authorization requests within defined guidelines.

The position is full-time with a standard M-F schedule, remote work nationwide, and a Virginia residency preference. You will operate in a high-volume, computer-based setting and support utilization management from home.

Qualifications

• Active, unrestricted COMPACT RN license in your state of residence.
• 3+ years of clinical nursing experience.
• Strong computer skills with the ability to navigate multiple systems.
• Ability to work Monday-Friday, 8:00 AM-5:00 PM, with occasional weekend/holiday on-call coverage.
• Associate’s degree in Nursing required.

Responsibilities

• Review clinical information and authorization requests using evidence-based guidelines and established criteria.
• Collaborate with healthcare providers to gather necessary documentation.
• Approve services within scope or refer complex cases to a Medical Director.
• Manage a high volume of cases in a fast-paced, phone and computer-based environment.

Skills

RN licensure

Clinical nursing

Computer literacy

Schedule flexibility

Education

Associate’s degree in Nursing

BSN

Tools

Microsoft Office 365

Job description

CVS Health Corporation is seeking a Remote UM Nurse Consultant RN Precertification for Telework. This role involves reviewing clinical information, collaborating with providers, and approving or referring authorization requests within defined guidelines.

The position is full-time with a standard M-F schedule, remote work nationwide, and a Virginia residency preference. You will operate in a high-volume, computer-based setting and support utilization management from home.