Remote Utilization Management RN Consultant

CVS Health; Pennsylvania; Remote; USD 40,000 - 86,000; Full time

Benefits offered by this job

Remote work

Comprehensive benefits

Bonus eligibility

Job summary

CVS Health is seeking a Registered Nurse for Utilization Management in a fully remote role. You will review clinical information, coordinate with care teams, and apply evidence-based guidelines to determine appropriate coverage and care plans from home.

Requires an active RN license and 2+ years in adult acute, critical care or medical-surgical settings. The role supports 24/7 operations with opportunities for growth and comprehensive benefits.

Qualifications

• Active, unrestricted RN license in your state.
• 2+ years RN experience in adult acute, critical care, or medical-surgical.
• Strong clinical judgment, communication, and multitasking skills.

Responsibilities

• Review clinical information and apply guidelines to make coverage decisions.
• Coordinate with providers and care teams to support treatment plans.
• Identify opportunities for care management referrals and improved utilization.
• Promote quality and patient outcomes.

Skills

RN license

Clinical judgment

Communication

Multitasking

Remote work ability

Education

Associate degree in nursing

BSN preferred

Tools

Microsoft Office 365

VPN / secure systems access

Job description

CVS Health is seeking a Registered Nurse for Utilization Management in a fully remote role. You will review clinical information, coordinate with care teams, and apply evidence-based guidelines to determine appropriate coverage and care plans from home.

Requires an active RN license and 2+ years in adult acute, critical care or medical-surgical settings. The role supports 24/7 operations with opportunities for growth and comprehensive benefits.