RN Utilization Management Consultant - Improve Care Access

CVS Health; Harrisburg (Dauphin County); On-site; USD 40,000 - 86,000; Full time

Benefits offered by this job

Medical coverage

Dental coverage

Vision coverage

Paid time off

Retirement savings

Job summary

CVS Health is seeking an experienced Registered Nurse for Utilization Management in a 24/7 operation in Harrisburg, PA. The role involves assessing, planning, coordinating, and evaluating care to ensure appropriate benefits for members. Requires active RN license and 2+ years in adult acute/critical care; utilization management experience is preferred.

The position includes weekends, holidays, and evenings. Associates degree required, BSN preferred. Anticipated weekly hours: 40.

Qualifications

• 2+ years of experience as a Registered Nurse in adult acute/critical care.
• Active, unrestricted RN licensure in the state of residence.
• Experience in Utilization Management is a plus.

Responsibilities

• Assess, plan, implement, coordinate, monitor and evaluate utilization/benefit options.
• Gather clinical information and apply criteria and guidelines to rendering coverage decisions.
• Communicate with providers to facilitate care and referrals.
• Identify opportunities to promote quality and efficient use of healthcare services.
• Collaborate with internal and external stakeholders in utilization management.

Skills

Registered Nurse

Adult Acute Care

Critical Care

Education

Associates Degree

BSN preferred

Job description

CVS Health is seeking an experienced Registered Nurse for Utilization Management in a 24/7 operation in Harrisburg, PA. The role involves assessing, planning, coordinating, and evaluating care to ensure appropriate benefits for members. Requires active RN license and 2+ years in adult acute/critical care; utilization management experience is preferred.

The position includes weekends, holidays, and evenings. Associates degree required, BSN preferred. Anticipated weekly hours: 40.