RN Utilization Manager - Remote Care Coordination

CVS Health; South Dakota; Ibrido; USD 36.000 - 94.000; Tempo pieno

Descrizione del lavoro

CVS Health is seeking an experienced Registered Nurse (RN) to join our Utilization Management team. You will review clinical information, apply guidelines, and coordinate care to ensure members receive the right care at the right time.

The role requires an active RN license, an associate degree in nursing, and 2+ years in adult acute or critical care. The position supports a 24/7 operation with various shifts and offers comprehensive benefits.

Competenze

• Active, unrestricted RN license in your state of residence.
• 2+ years of RN experience in an adult acute care or critical care setting.
• 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.

Conoscenze

RN license in state of residence

Communication

multitasking

Computer navigation

Formazione

Associates Degree in Nursing

Strumenti

Microsoft Office 365

EHR portal

Descrizione del lavoro

CVS Health is seeking an experienced Registered Nurse (RN) to join our Utilization Management team. You will review clinical information, apply guidelines, and coordinate care to ensure members receive the right care at the right time.

The role requires an active RN license, an associate degree in nursing, and 2+ years in adult acute or critical care. The position supports a 24/7 operation with various shifts and offers comprehensive benefits.