Remote Utilization Nurse Consultant

CVS Health; United States; Remote; USD 40,000 - 86,000; 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 a licensed Registered Nurse for a remote, full-time Utilization Management role focused on weekend coverage. The position supports Saturday and Sunday shifts, with schedules including four 10-hour shifts or other approved configurations.

You will assess, plan, implement, coordinate, and evaluate care and benefits for members, coordinating with providers and internal teams to promote quality and appropriate utilization. Competitive pay and comprehensive benefits are offered.

Qualifications

• Registered Nurse with active licensure in home state.
• Diploma RN acceptable; Associate degree/BSN preferred.
• 3+ years of RN experience; 1+ years in acute or post-acute; 1+ years in Utilization Management / Care Management.

Responsibilities

• Gather clinical information and apply clinical criteria to render coverage determinations.
• Communicate with providers to facilitate care and identify referral opportunities.
• Identify opportunities to promote quality and control utilization.
• Consult internal/external constituents in utilization/benefit management.
• Meet productivity and quality expectations as established by UMNC.

Skills

RN

Communication skills

Computer proficiency

Multitasking

Education

Diploma RN acceptable

Associate degree/BSN preferred

Job description

CVS Health is seeking a licensed Registered Nurse for a remote, full-time Utilization Management role focused on weekend coverage. The position supports Saturday and Sunday shifts, with schedules including four 10-hour shifts or other approved configurations.

You will assess, plan, implement, coordinate, and evaluate care and benefits for members, coordinating with providers and internal teams to promote quality and appropriate utilization. Competitive pay and comprehensive benefits are offered.