# Registered Nurse (RN) – Utilization Management

**Company**: CVS Health
**Location**: Work from home, PA, PA
**Work arrangement**: remote
**Experience**: senior
**Job type**: full-time
**Salary**: $29.10 - $68.55
**Category**: Healthcare
**Industry**: Healthcare

**Apply**: https://cvshealth.wd1.myworkdayjobs.com/en-US/CVS_Health_Careers/job/PA---Work-from-home/Utilization-Management-Nurse-Consultant_R0991964?utm_source=yubhub.co&utm_medium=jobs_feed&utm_campaign=apply
**Canonical**: https://yubhub.co/jobs/job_9968b8f0-410

## Description

We're building a world of health around every individual , shaping a more connected, convenient and compassionate health experience.

As a Registered Nurse (RN) – Utilization Management, you will join a fast-paced, collaborative team to help ensure members receive the appropriate care and benefits while making a meaningful impact on healthcare outcomes.

**Responsibilities**

- Review clinical information and apply evidence-based criteria to support coverage determinations

- Assess, coordinate, monitor, and evaluate healthcare services across the continuum of care

- Collaborate with providers and care teams to facilitate appropriate treatment plans

- Identify opportunities to improve quality, efficiency, and healthcare utilization

- Connect members to additional programs and services as appropriate

- Serve as a clinical resource for internal and external stakeholders

**Requirements**

- Active, unrestricted RN license in your state of residence

- 2+ years of adult acute care and/or critical care nursing experience

- Strong clinical assessment and decision-making skills

- Ability to navigate multiple computer systems and manage competing priorities

- Excellent verbal and written communication skills

- Associate Degree in Nursing required

- Willing to work weekends, holidays, and evening shifts

**Preferred Qualifications**

- 2+ years of Med-Surg or specialty nursing experience

- Managed Care experience, particularly Utilization Management

- Reside in the Eastern Time Zone

- BSN preferred

**Benefits**

- Medical, dental, and vision coverage

- Paid time off

- Retirement savings options

- Wellness programs

- Other resources, based on eligibility

**Technical and Logistical Requirements**

- Device & System Navigation: Comfortable setting up and using multiple monitors and navigating multiple applications simultaneously to streamline tasks and improve efficiency

- Communication Tools: Ability to communicate on digital channels such as via email, calendar invites, Teams messaging, and virtual meetings

- Collaboration & Scheduling: Experience with Microsoft Office 365 (Teams, Outlook, Word, Excel, PowerPoint) applications or similar (Google Workspace)

- Systems Access & Security: Ability to Log in to secure systems (e.g., VPN, EHR portal), lock a computer screen when unattended, manage strong passwords, and recognize suspicious emails or links

- Troubleshooting & Support: Ability to resolve common technical issues independently, such as: restarting an application when frozen, resolving internet connection issues, and contacting IT for unresolved technical issues

**Anticipated Weekly Hours**

- 40

**Time Type**

- Full time

**Pay Range**

- $29.10 - $68.55

## Skills

### Required
- RN license
- clinical assessment
- decision-making
- communication skills
- Associate Degree in Nursing

### Nice to have
- Med-Surg experience
- Managed Care experience
- Utilization Management
- BSN

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Source: [Apply at cvshealth.wd1.myworkdayjobs.com](https://cvshealth.wd1.myworkdayjobs.com/en-US/CVS_Health_Careers/job/PA---Work-from-home/Utilization-Management-Nurse-Consultant_R0991964?utm_source=yubhub.co&utm_medium=jobs_feed&utm_campaign=apply)