Remote Utilization Management RN

CVS Health; Miami (FL); A distancia; USD 36.000 - 103.000; Jornada completa

Ventajas ofrecidas por este puesto de trabajo

Medical, dental, vision coverage

Paid time off

Retirement savings options

Wellness programs

Descripción de la vacante

CVS Health is seeking an experienced Registered Nurse (RN) to join the Utilization Management team in a remote capacity. You will review clinical information to support coverage determinations and apply evidence-based criteria across the continuum of care.

The role requires collaboration with providers and interdisciplinary teams to improve quality and optimize benefits. Preferred candidates hold 2+ years of Med-Surg or specialty clinical experience, an active RN license in the resident state,

Formación

• Active, unrestricted RN license in your state of residence.
• Minimum 2 years of RN experience in an adult acute care or critical care setting.
• Associates degree in nursing.

Responsabilidades

• Review and assess clinical information to support coverage determinations and recommendations.
• Apply evidence-based clinical criteria, policies, and professional judgment across the continuum of care.
• Collaborate with providers and interdisciplinary teams to coordinate care and promote positive member outcomes.
• Identify opportunities for quality improvement, care integration, and effective benefit utilization.
• Serve as a clinical resource for internal and external stakeholders.

Conocimientos

RN license

Utilization Management

Educación

Associates degree in nursing

Descripción del empleo

CVS Health is seeking an experienced Registered Nurse (RN) to join the Utilization Management team in a remote capacity. You will review clinical information to support coverage determinations and apply evidence-based criteria across the continuum of care.

The role requires collaboration with providers and interdisciplinary teams to improve quality and optimize benefits. Preferred candidates hold 2+ years of Med-Surg or specialty clinical experience, an active RN license in the resident state,