Remote Utilization Nurse Consultant for Care Optimization

CVS Health; Sacramento (CA); Remote; USD 44,000 - 94,000; Full time

Job summary

CVS Health in Sacramento, CA seeks a registered nurse to support Utilization Management in a 24/7 operation. This full-time role includes evaluating care options, applying clinical criteria, coordinating with providers, and promoting efficient use of benefits.

Associates degree is required; BSN is preferred. The position requires weekend/evening shifts and a strong commitment to patient care in a remote-friendly environment.

Qualifications

• 2+ years RN experience in adult acute/critical care.
• Active RN license in state of residence.
• Availability for 24/7 schedule including weekends and evenings.

Responsibilities

• Assess, plan, coordinate and evaluate options to facilitate appropriate care.
• Gathers clinical information and applies criteria to render coverage decisions.
• Communicate with providers to coordinate care and identify referral opportunities.
• Promote quality and effective use of healthcare services and benefits.
• Consult with internal and external stakeholders in utilization/benefit management.

Skills

RN licensure

Utilization management

Clinical assessment

Communication skills

Multitasking

Education

Associate degree

BSN preferred

Tools

Microsoft Office 365

Job description

CVS Health in Sacramento, CA seeks a registered nurse to support Utilization Management in a 24/7 operation. This full-time role includes evaluating care options, applying clinical criteria, coordinating with providers, and promoting efficient use of benefits.

Associates degree is required; BSN is preferred. The position requires weekend/evening shifts and a strong commitment to patient care in a remote-friendly environment.