Utilization Management Nurse Consultant - Remote

Overview

The Utilization Management Nurse Consultant at CVS Health plays a vital role in assessing and coordinating healthcare services for members, utilizing clinical expertise to ensure appropriate benefit utilization.

In Short

• Collaborate to assess and implement healthcare services.
• Utilize clinical experience for coverage determination.
• Communicate with providers to facilitate care.
• Identify opportunities for quality improvement.
• Consult on utilization management processes.
• Work in a typical office environment with productivity expectations.
• Requires effective multitasking and prioritization.
• Full-time position with varied work hours.
• Proficiency in computer skills is necessary.
• Requires active RN licensure in the state of residence.

Requirements

• 2+ years of experience as a Registered Nurse.
• Active RN licensure required.
• Clinical experience in med surg or specialty area preferred.
• Managed Care experience is a plus.
• Associates Degree required; BSN preferred.
• Ability to work weekends, holidays, and evenings.
• Strong communication skills required.
• Proficiency in navigating multiple systems.

Benefits

• Comprehensive medical plan options.
• 401(k) plan with company matching.
• No-cost wellness programs available.
• Flexible work schedules and paid time off.
• Tuition assistance for further education.
• Employee stock purchase plan.
• Confidential counseling and financial coaching.
• Dependent care resources available.