Utilization Management RN Consultant — Weekend/Weekday

CVS Health; United States; Remote; USD 36,000 - 77,000; Full time

Benefits offered by this job

Medical coverage

Dental coverage

Vision coverage

Paid time off

Retirement savings options

Wellness programs

Job summary

CVS Health is seeking an RN for Utilization Management with a weekend schedule. The role involves assessing and coordinating care, applying clinical criteria, and communicating with providers to ensure appropriate services and benefits.

Requires an active RN license (KY or compact) and 3+ years of clinical experience; proficiency with EMR systems and navigating multiple platforms is expected. Full-time position with a comprehensive benefits package.

Qualifications

• Must have ability to work a Weekend position (Sat/Sun + 2 weekdays).
• Active, current and unrestricted RN licensure in Kentucky or multi-state license.
• 3+ years of clinical experience.
• Proficiency with computer skills including navigating multiple systems.
• Ability to work in a fast paced environment.

Responsibilities

• Assess, plan, implement, coordinate, monitor and evaluate options to facilitate healthcare services for members.
• Gather clinical information and apply criteria to render coverage determinations.
• Communicate with providers to facilitate care and identify referral opportunities.
• Promote quality use of healthcare services and benefits.
• Consult with internal and external constituents in utilization/benefit management.

Skills

RN licensure

Clinical experience

Computer skills

Fast-paced environment

Weekend schedule

Education

Associate's degree

BSN preferred

Tools

EMR software

Navigate multiple systems

Job description

CVS Health is seeking an RN for Utilization Management with a weekend schedule. The role involves assessing and coordinating care, applying clinical criteria, and communicating with providers to ensure appropriate services and benefits.

Requires an active RN license (KY or compact) and 3+ years of clinical experience; proficiency with EMR systems and navigating multiple platforms is expected. Full-time position with a comprehensive benefits package.