Utilization Management Nurse Consultant - Remote

Overview

The Utilization Management Nurse Consultant at CVS Health plays a crucial role in coordinating and managing healthcare services for members, utilizing clinical skills and judgment to ensure appropriate care delivery.

In Short
? Utilize clinical skills for utilization/benefit management.
? Coordinate and document healthcare services for members.
? Communicate with providers to facilitate care.
? Identify referral opportunities for integrated services.
? Consult with internal and external parties on management functions.
? Work in a typical office environment with productivity expectations.
? Must be able to work weekends, holidays, and evenings.
? Proficiency in computer skills is required.
? Effective verbal and written communication skills are essential.
? 3+ years of experience as a Registered Nurse is required.
Requirements
? Active RN licensure in state of residence.
? 1+ years of clinical experience in acute or post-acute settings.
? Availability for a minimum of 6 weekend rotations per year.
? Willingness to work Monday through Friday in specified time zones.
? 3+ years of clinical experience preferred.
? Managed Care experience is a plus.
? Associates Degree required; BSN preferred.
Benefits
? Full range of medical, dental, and vision benefits.
? 401(k) retirement savings plan available.
? Employee Stock Purchase Plan for eligible employees.
? Fully-paid term life insurance for eligible employees.
? Short-term and long-term disability benefits offered.
? Paid Time Off (PTO) and paid holidays provided.
? Numerous well-being programs and education assistance.
? Discount programs with participating partners.
? Free development courses available.
? CVS store discount for employees.