Utilization Management Nurse Consultant-Central Time Zone Preferred

CVS Health•Work At Home-Illinois, IL

3d•$32 - $69•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. Registered Nurse (RN) – Utilization Management. Make an impact on patient care from wherever you are. We’re seeking an experienced Registered Nurse (RN) to join our Utilization Management team, where you'll use your clinical expertise to help ensure members receive the right care at the right time.

Requirements

Active, unrestricted RN license in state of residence
Minimum 2 years of RN experience in adult acute care or critical care
Strong clinical assessment, communication, and computer skills
Ability to thrive in a fast-paced, high-volume environment
Associates Degree in Nursing

Nice To Haves

Experience in Medical-Surgical or specialty nursing
Managed Care and/or Utilization Management experience
BSN preferred
Candidates residing in Central Time Zone preferred

Responsibilities

Review and assess clinical information to support coverage and care decisions
Apply clinical guidelines, policies, and professional judgment across the continuum of care
Collaborate with providers and interdisciplinary teams to coordinate treatment and services
Identify opportunities for care management referrals and member support programs
Promote quality, effective healthcare utilization, and positive member outcomes
Serve as a clinical resource for internal and external stakeholders