Description
We're building a world of health around every individual , shaping a more connected, convenient and compassionate health experience.
At CVS Health, you'll be surrounded by colleagues who care deeply, innovate with purpose, hold themselves accountable and prioritize safety and quality in everything they do.
Utilization Management Nurse (RN) | Remote
Are you an experienced Registered Nurse looking to leverage your clinical expertise in a collaborative, fast-paced environment? Join our Utilization Management team and play a critical role in helping members receive the appropriate care and benefits they need.
Responsibilities
- Review clinical information and apply evidence-based criteria to support coverage determinations
- Collaborate with providers and interdisciplinary teams to coordinate care and optimize outcomes
- Identify opportunities to improve healthcare quality, efficiency, and member experience
- Support members by connecting them with additional programs and services when appropriate
- Serve as a clinical resource for utilization and benefit management activities
Requirements
- Active, unrestricted RN license in your state of residence
- 2+ years of RN experience in adult acute care or critical care
- Associate Degree in Nursing (ADN)
Preferred Qualifications
- BSN
- Strong clinical judgment, communication, and computer skills
- Experience in Medical-Surgical or specialty nursing
- Utilization Management or Managed Care experience
- Candidates located in the Eastern or Central Time Zone
Work Environment
- Fully remote office environment
- Fast-paced, team-oriented setting with productivity and quality goals
- Schedule flexibility required, including evenings, weekends, and holidays as part of a 24/7 operation
Benefits
- Medical, dental, and vision coverage
- Paid time off
- Retirement savings options
- Wellness programs
Pay Range
$26.01 - $74.78 per hour
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