Remote Utilization Nurse Consultant - Care Optimization

CVS Health; Texas; Remoto; USD 36.000 - 85.000; Tempo pieno

Vantaggi offerti da questo lavoro

Medical coverage

Dental coverage

Vision coverage

PTO

Descrizione del lavoro

CVS Health is hiring an Utilization Management Nurse Consultant to enhance patient outcomes through clinical assessment in a remote environment. The role emphasizes collaboration with care teams, applying guidelines, and coordinating treatment plans to ensure appropriate care and utilization management.

The RN with 3+ years of experience, including Med/Surg, and an Associate’s degree (BSN preferred) will support coverage decisions and connect members to additional services as needed.

Competenze

• Associate’s degree required, BSN preferred.
• 3+ years of RN experience.
• 1+ year Med/Surg experience.

Mansioni

• Review and assess clinical information to support coverage determinations.
• Apply clinical guidelines, policies, and sound judgment across the care continuum.
• Collaborate with providers and care teams to coordinate treatment plans.
• Identify opportunities to enhance quality, efficiency, and member outcomes.
• Refer members to additional programs and services as appropriate.
• Serve as a clinical resource within utilization/benefit management.

Conoscenze

RN experience

Med/Surg experience

Formazione

Associate’s degree

BSN

Descrizione del lavoro

CVS Health is hiring an Utilization Management Nurse Consultant to enhance patient outcomes through clinical assessment in a remote environment. The role emphasizes collaboration with care teams, applying guidelines, and coordinating treatment plans to ensure appropriate care and utilization management.

The RN with 3+ years of experience, including Med/Surg, and an Associate’s degree (BSN preferred) will support coverage decisions and connect members to additional services as needed.