RN Utilization & Care Coordination Specialist

CVS Health; Salem (NH); Remote; USD 36,000 - 77,000; Full time

Benefits offered by this job

Medical coverage

Dental coverage

Vision coverage

Paid time off

Retirement options

Wellness programs

Job summary

CVS Health is seeking a Registered Nurse to assess, plan, implement and coordinate healthcare services for members in a remote capacity. This role involves evaluating needs, applying clinical criteria, and communicating with providers to support care decisions.

The ideal candidate has 2+ years of adult acute/critical care experience, an active RN license in their state, and availability for weekends and evenings. An Associate degree is required, with a Bachelor’s degree preferred.

Qualifications

• EST residency required.
• Active RN license in state of residence.
• 2+ years RN experience in adult acute/critical care.
• Available to work weekends, holidays and evenings.

Responsibilities

• Assess, plan, implement and coordinate healthcare services for members.
• Render coverage determinations using clinical criteria and guidelines.
• Communicate with providers to facilitate care.
• Identify referral opportunities to integrate programs and services.
• Promote quality and appropriate utilization of healthcare services.
• Collaborate with internal/external teams on utilization management.

Skills

RN license

Acute/CCU experience

Weekend/evening availability

Clinical communication

Education

Associates Degree in Nursing

Bachelor's Degree preferred

Tools

MS Office 365

Google Workspace

Job description

CVS Health is seeking a Registered Nurse to assess, plan, implement and coordinate healthcare services for members in a remote capacity. This role involves evaluating needs, applying clinical criteria, and communicating with providers to support care decisions.

The ideal candidate has 2+ years of adult acute/critical care experience, an active RN license in their state, and availability for weekends and evenings. An Associate degree is required, with a Bachelor’s degree preferred.