View All Jobs 167
Remote Utilization Management Nurse Consultant, California - Remote Eligible
Implement strategies to enhance the personalization, convenience, and affordability of healthcare services.
Remote
Senior
$30.39-$65.66 USD per hour
3 months ago
✨ About The Role
- Utilize clinical experience and skills to assess, plan, implement, coordinate, monitor, and evaluate options for healthcare services for members
- Apply appropriate clinical criteria, guidelines, policies, procedures, and clinical judgment to render coverage determinations/recommendations
- Communicate with providers and other parties to facilitate care/treatment
- Identify members for referral opportunities to integrate with other products, services, and programs
- Consult and lend expertise to internal and external constituents in the coordination and administration of the utilization/benefit management function
âš¡ Requirements
- Experienced Registered Nurse with at least 3 years of clinical experience in an acute or post-acute setting
- Must have an active and unrestricted RN licensure in the state of residence
- Ability to work Monday through Friday, 8am to 5pm in the time zone of residence
- Proficient in computer skills and navigating multiple systems
- Strong communication skills, both verbal and written
Remote Utilization Management Nurse Consultant, California - Remote Eligible
Remote
$30.39-$65.66 USD per hour
Registered Nurse
About CVS Health
Enabling a more transparent, simple health care system