RN Utilization Manager — Remote Care Coordination

CVS Health

Oregon

Ibrido

USD 36.000 - 94.000

Tempo pieno

3 giorni fa

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Descrizione del lavoro

CVS Health is seeking an experienced Registered Nurse (RN) to join our Utilization Management team, helping ensure members receive appropriate care at the right time through evidence-based clinical review and care coordination.

The role involves reviewing clinical information, applying guidelines, collaborating with providers, and promoting care management initiatives to optimize health outcomes. A flexible schedule supporting a 24/7 operation is required.

Competenze

Active, unrestricted RN license in your state of residence.
2+ years of RN experience in adult acute or critical care.
Strong communication, multitasking, and computer navigation skills.
Ability to work a flexible schedule, including evenings, weekends and holidays in a 24/7 operation.
Associates Degree in Nursing required.

Mansioni

Review and assess clinical information to support coverage determinations and care recommendations.
Apply clinical guidelines, policies, and professional judgment across the continuum of care.
Collaborate with providers and healthcare teams to facilitate quality patient outcomes.
Identify opportunities for care management referrals and member support programs.
Promote effective healthcare utilization and quality improvement initiatives.