Utilization Management Nurse Consultant - Remote

Overview

As a Utilization Management Nurse Consultant at CVS Health, you will leverage your clinical experience to assess and facilitate appropriate healthcare services for members, ensuring quality and effectiveness in healthcare delivery.

In Short

• Utilizes clinical experience to assess healthcare options.
• Coordinates and evaluates healthcare services for members.
• Communicates with providers to facilitate care.
• Identifies referral opportunities for integrated care.
• Works in a 24/7 operation with varied schedules.
• Requires proficiency in computer skills and multitasking.
• Ensures adherence to clinical criteria and guidelines.
• Must have active RN licensure in state of residence.
• Preferred experience in managed care and utilization management.
• Offers a competitive pay range and comprehensive benefits.

Requirements

• 2+ years of experience as a Registered Nurse in acute care.
• Active RN licensure in state of residence.
• Ability to work weekends, holidays, and evenings.
• Associates Degree required; BSN preferred.
• Experience in med surg or specialty area preferred.
• Strong communication skills, both verbal and written.
• Ability to adapt to a fast-paced environment.
• Experience in managed care is a plus.

Benefits

• Affordable medical plan options.
• 401(k) plan with company matching contributions.
• No-cost wellness programs and counseling services.
• Flexible work schedules and paid time off.
• Tuition assistance and retiree medical access.
• Comprehensive benefits tailored to employee needs.
• Employee stock purchase plan available.
• Support for physical, emotional, and financial wellness.