Remote Utilization Management RN - Impactful Care Leader

CVS Health; Topeka (KS); Remote; USD 54,000 - 117,000; Full time

Benefits offered by this job

Medical, dental, and vision coverage

Paid time off

Retirement savings options

Wellness programs

Job summary

CVS Health is seeking an experienced Registered Nurse (RN) for Utilization Management in a remote, work-from-home role. You will review clinical data, apply guidelines and collaborate with care teams to ensure appropriate, high-quality, cost-effective care for members.

Qualified candidates hold an active RN license, 2+ years in acute or critical care, with strong assessment and multitasking abilities. Central Time Zone preferred; BSN is a plus.

Qualifications

• Active, unrestricted RN license in your state of residence.
• 2+ years of adult acute care and/or critical care nursing experience.
• Strong clinical assessment, critical thinking and communication skills.
• Ability to multitask in a fast-paced environment.
• Proficiency navigating multiple computer systems and applications.
• Associate Degree in Nursing required.

Responsibilities

• Review clinical information and apply guidelines to support coverage determinations.
• Assess, coordinate, monitor and evaluate healthcare services across care continuum.
• Collaborate with providers and care teams to facilitate appropriate treatment.
• Identify opportunities to improve quality of care and member outcomes.
• Connect members with programs and resources when appropriate.
• Serve as a clinical resource for internal and external stakeholders.

Skills

Clinical assessment

Critical thinking

Communication skills

Multitasking

Education

Associate Degree in Nursing

BSN preferred

Tools

Microsoft Office 365

Job description

CVS Health is seeking an experienced Registered Nurse (RN) for Utilization Management in a remote, work-from-home role. You will review clinical data, apply guidelines and collaborate with care teams to ensure appropriate, high-quality, cost-effective care for members.

Qualified candidates hold an active RN license, 2+ years in acute or critical care, with strong assessment and multitasking abilities. Central Time Zone preferred; BSN is a plus.