Utilization Management Nurse Consultant - Remote

Overview

The Utilization Management Nurse Consultant at CVS Health is responsible for applying clinical criteria and guidelines to authorize healthcare services, working in a collaborative process to facilitate appropriate care for members.

In Short

• Utilization Management role requiring critical thinking and clinical judgment.
• Work schedule includes weekends, holidays, and evening hours.
• Involves desk work and phone communication with providers.
• Requires active RN licensure in the state of residence.
• 3+ years of clinical experience required.
• Proficiency in navigating multiple computer systems needed.
• Ability to work in a fast-paced environment is essential.
• Preferred experience in prior authorization.
• Education: Associate's degree required; BSN preferred.
• 40 hours per week with a competitive pay range.

Requirements

• Active, current, and unrestricted compact RN licensure.
• 3+ years of clinical experience.
• 1+ years of experience with computer skills.
• Willingness to work Monday through Friday 8:00am to 5:00pm CST.
• Ability to perform sedentary work involving periods of sitting.
• Effective verbal and written communication skills.

Benefits

• Comprehensive medical plan options.
• 401(k) plan with company matching.
• No-cost wellness programs and counseling services.
• Flexible work schedules and paid time off.
• Tuition assistance and retiree medical access.