Utilization Management Nurse Consultant – Preference for Virginia Residents

CVS Health Corporation; Virginia (MN); On-site; USD 40,000 - 85,000; Full time

Benefits offered by this job

Medical, dental, and vision coverage

Paid time off

Retirement savings options

Wellness programs and other resources

Job summary

CVS Health is seeking an experienced Registered Nurse for a fully remote Utilization Management Nurse Consultant role. This position is ideal for individuals who thrive in a fast-paced environment and are looking to make a clinical impact without direct patient care.

Highlights include a remote role in VA with Virginia residency or Compact license preference, and a schedule of Mon-Fri, 8:00 AM-5:00 PM with potential on-call coverage. Prior authorization experience is valued.

Qualifications

• Associate's degree in Nursing required.
• 3+ years of clinical nursing experience required.
• Active, unrestricted COMPACT RN license in your state of residence required.
• Compact RN license preferred.
• BSN preferred.

Responsibilities

• Review clinical information and authorization requests using evidence-based guidelines.
• Collaborate with healthcare providers to gather necessary documentation.
• Approve services within scope or refer complex cases to a Medical Director.
• Manage a high volume of cases in a fast-paced, phone and computer-based environment.

Skills

Utilization management

Clinical nursing

Remote work

Education

Associate's degree in Nursing

BSN (preferred)

Job description

About This Role

CVS Health is seeking an experienced Registered Nurse for a fully remote Utilization Management Nurse Consultant role. This position is ideal for individuals who thrive in a fast-paced environment and are looking to make a clinical impact without direct patient care.

Highlights

• Pay: $29.10 - $62.32/hour
• Location: Remote, VA
• Residency: Preference for Virginia residents or candidates holding both Virginia and Compact RN licenses
• Schedule: Full-time, Monday-Friday, 8:00 AM-5:00 PM, with occasional weekend/holiday on-call coverage

What You Will Do

• Review clinical information and authorization requests using evidence-based guidelines
• Collaborate with healthcare providers to gather necessary documentation
• Approve services within scope or refer complex cases to a Medical Director
• Manage a high volume of cases in a fast-paced, phone and computer-based environment

Requirements

• Education:
  • Associate's degree in Nursing required
• Experience:
  • 3+ years of clinical nursing experience required
  • Prior authorization or utilization management experience preferred
• Licenses & Certifications:
  • Active, unrestricted COMPACT RN license in your state of residence required
  • Compact RN license preferred
  • BSN preferred

Benefits

• Medical, dental, and vision coverage
• Paid time off
• Retirement savings options
• Wellness programs and other resources

About CVS Health

CVS Health is a leading healthcare provider committed to delivering exceptional patient care. They focus on creating a more connected, convenient, and compassionate health experience for individuals and communities.