Utilization Management Nurse Consultant

CVS Health • Work At Home-Arkansas, AR

1d • $26 - $56 • Remote

About The Position

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 passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. Location: Remote (CST/MST preferred) Schedule: Monday – Friday 8:00 am to 5:00 pm in their time zone. Utilization Management is a 24/7 operation – schedules include evenings, weekends, and holidays. Make an impact beyond the bedside. Join our Utilization Management team and help ensure members receive the most appropriate, high-quality care across the healthcare continuum.

Requirements

• Active, unrestricted RN license in state of residence (required)
• 2+ years of adult acute or critical care experience
• Strong clinical judgment, communication, and multitasking skills
• Comfort working in a fast-paced, technology-driven environment

Nice To Haves

• Associates Degree in Nursing
• Med-Surg or specialty clinical experience
• Managed care or Utilization Management experience
• BSN preferred
• Located in CST or MST

Responsibilities

• Review clinical information and apply evidence-based guidelines to make coverage determinations
• Collaborate with providers and care teams to coordinate services and support treatment plans
• Identify opportunities to improve care quality, efficiency, and member outcomes
• Connect members to additional programs and resources
• Serve as a clinical resource for internal and external partners

Benefits

• medical
• dental
• vision coverage
• paid time off
• retirement savings options
• wellness programs

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: Associate degree