Remote Utilization Management RN Consultant

CVS Health Corporation; Richmond (VA); Remote; USD 4,009,000 - 8,585,000; Full time

Job summary

CVS Health Corporation in the United States is seeking a Utilization Management Nurse Consultant to coordinate, document, and communicate all aspects of the utilization/benefit management program. This 100% remote role requires applying clinical expertise to assure medical necessity and appropriate discharge planning, while collaborating with facilities and providers to meet complex member needs.

Preferred candidates hold an active RN license, at least 3 years of acute hospital experience,

Qualifications

• Active RN license in state of residence
• Minimum 3 years of acute hospital RN experience
• Ability to use a computer with multiple screens and run several programs
• A private workspace with high-speed internet
• Willingness to work Monday–Friday 8am–5pm EST with occasional weekend on-call/holiday rotation

Responsibilities

• Coordinate, document and communicate utilization/benefit management activities
• Review clinical records to determine medical necessity
• Ensure appropriate care timing and location for members
• Facilitate discharge planning and collaborate with facilities and providers to meet complex needs

Skills

RN license

Acute hospital RN experience

Multi-screen computer use

Private workspace with internet

Education

Associate’s Degree

BSN

Tools

PowerPoint

Excel

Word

Microsoft Office

Job description

CVS Health Corporation in the United States is seeking a Utilization Management Nurse Consultant to coordinate, document, and communicate all aspects of the utilization/benefit management program. This 100% remote role requires applying clinical expertise to assure medical necessity and appropriate discharge planning, while collaborating with facilities and providers to meet complex member needs.

Preferred candidates hold an active RN license, at least 3 years of acute hospital experience,