Utilization Management Nurse Consultant - Remote

Overview

The Utilization Management Nurse Consultant role at CVS Health is a fully remote position focused on transforming healthcare through dedicated service. This position requires clinical skills to coordinate and manage healthcare services efficiently.

In Short

• Fully remote role in the USA.
• Requires Monday-Friday shifts with variable hours based on time zones.
• Utilizes clinical skills for utilization/benefit management.
• Communicates with providers to facilitate care/treatment.
• Requires a Registered Nurse license with multi-state privileges.
• 1 year of utilization management experience required.
• 5 years of clinical experience required.
• Participates in mandatory training for the first 3 weeks.
• Eligible for bonuses and various employee benefits.
• Great benefits including medical plans and 401(k) options.

Requirements

• 1 year of UM, concurrent review, or prior authorization experience.
• 5 years of clinical experience.
• Proficient in clinical documentation systems.
• Ability to make independent clinical decisions.
• Registered Nurse with an unrestricted license.
• Preferred: 1+ years in Managed Care and high-volume clinical call centers.
• Education: Associate's nursing degree required; Bachelor's preferred.

Benefits

• Comprehensive medical plan options.
• 401(k) plan with matching contributions.
• Employee stock purchase plan.
• No-cost wellness programs and counseling.
• Flexible work schedules and paid time off.
• Tuition assistance and family leave options.
• Dependent care resources and colleague assistance programs.