RN Utilization Manager — Remote Care Optimization

CVS Health; Louisiana; Ibrido; USD 36.000 - 94.000; Tempo pieno

Vantaggi offerti da questo lavoro

Medical, dental, and vision coverage

Paid time off

Retirement savings options

Wellness programs

Descrizione del lavoro

CVS Health is hiring an experienced Registered Nurse (RN) for Utilization Management. In this role you will review clinical information to support coverage determinations, apply guidelines, and coordinate care to ensure appropriate, high-quality outcomes.

This full-time, remote position requires an active RN license, 2+ years in adult acute or critical care, and strong communication. Associates degree in nursing is required, with preferred Med-Surg or utilization management experience.

Competenze

• Active, unrestricted RN license in your state of residence.
• 2+ years of RN experience in an adult acute care or critical care setting.
• Strong communication, multitasking, and computer navigation skills.
• Ability to work a flexible schedule, including evenings, weekends, and holidays as part of 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.

Conoscenze

RN license

Acute/critical care

Care coordination

Clinical review

Communication skills

Flexible schedule

Formazione

Associates Degree in Nursing

Strumenti

EHR systems

VPN access

Microsoft Office 365

Descrizione del lavoro

CVS Health is hiring an experienced Registered Nurse (RN) for Utilization Management. In this role you will review clinical information to support coverage determinations, apply guidelines, and coordinate care to ensure appropriate, high-quality outcomes.

This full-time, remote position requires an active RN license, 2+ years in adult acute or critical care, and strong communication. Associates degree in nursing is required, with preferred Med-Surg or utilization management experience.