Remote Utilization Management RN Consultant

CVS Health; Colorado; À distance; USD 40 000 - 85 000; Plein temps

Avantages offerts par ce poste

Medical, dental, and vision coverage

Paid time off

Retirement savings options

Wellness programs and other resources

Résumé du poste

CVS Health is seeking a Utilization Management Nurse Consultant to assess, plan, implement, and coordinate healthcare services for members in a collaborative environment. This role leverages clinical expertise to determine coverage and support care decisions.

The position is remote with Colorado presence, full-time schedule, and requires RN licensure with 3+ years of nursing experience including Med/Surg; BSN preferred.

Qualifications

• Associates degree required, BSN preferred.
• 3+ years of experience as a Registered Nurse.
• 1+ years of Med/Surg experience.
• 1+ years of experience with Microsoft Office applications.

Responsabilités

• Assess and evaluate healthcare services for members.
• Gather clinical information and apply criteria to render coverage determinations.
• Communicate with providers to facilitate care and treatment.
• Identify members for referral opportunities to integrate with other services and programs.
• Promote quality and effectiveness of healthcare services and benefit utilization.
• Consult with internal and external constituents on utilization management functions.

Connaissances

Clinical assessment

Care coordination

Communication with providers

Formation

Associate degree

BSN preferred

Outils

Microsoft Office

Description du poste

CVS Health is seeking a Utilization Management Nurse Consultant to assess, plan, implement, and coordinate healthcare services for members in a collaborative environment. This role leverages clinical expertise to determine coverage and support care decisions.

The position is remote with Colorado presence, full-time schedule, and requires RN licensure with 3+ years of nursing experience including Med/Surg; BSN preferred.