Utilization Management Nurse Consultant

Job not on LinkedIn

🔥 51 minutes ago

🦌 Connecticut – Remote

🦌 Connecticut – Remote

💵 $26 - $74 / hour

⏰ Full Time

🟢 Junior

🟡 Mid-level

💼 Consultant

👻 Ghost score 0%

What it means: the chance that no one is really hiring for this job.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.Why this score:

• Just posted.
• Jobs at this company usually fill in 21 days.

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CVS Health Careers

WebsiteLinkedInAll Job Openings

10,000+ employees

🏥 Healthcare

🛒 Retail

📦 Logistics

Healthcare • Retail • Logistics

CVS Health Careers is the recruitment and employer branding arm of CVS Health, showcasing job opportunities across the company's broad operations—pharmacy retail stores, pharmacy services, health care clinics, distribution warehouses, corporate functions and transportation. The careers site emphasizes purpose-driven work focused on improving access, affordability and quality of health care, and highlights a large workforce (300,000+ employees), inclusive culture, benefits, and hiring resources for applicants.

📋 Description

• Review clinical information and apply evidence-based criteria to coverage determinations • Collaborate with providers, care teams, and internal partners to support quality patient care • Identify opportunities for care coordination and program referrals • Promote effective healthcare utilization and positive member outcomes • Document decisions and navigate multiple systems while meeting productivity and quality goals • Work a schedule that may include evenings, weekends, and holidays in a 24/7 utilization management operation

🎯 Requirements

• Active, unrestricted RN license in your state of residence • Minimum 2 years of RN experience in adult acute care, critical care, med-surg, or a specialty area • Associate Degree in Nursing • Utilization Management or Managed Care experience preferred • BSN preferred • Strong clinical assessment, communication, and critical thinking skills • Ability to multitask and thrive in a technology-driven environment • Residence in the Eastern Time Zone preferred • Availability for schedules that may include evenings, weekends, and holidays • Direct/hardwired internet connection to a modem/router within 7 feet of the computer • Minimum internet speed of 25 Mbps download and 3 Mbps upload • Quiet, secure, private designated home workspace compliant with CVS Health and HIPAA guidelines • Must work within the state and city where currently living • Ability to set up and use multiple monitors and navigate multiple applications • Ability to communicate via email, calendar invites, Teams messaging, and virtual meetings • Experience with Microsoft Office 365 applications or similar Google Workspace tools • Ability to log in to secure systems such as VPN and EHR portals • Ability to follow computer security practices, manage strong passwords, and recognize suspicious emails or links • Ability to resolve common technical issues independently • Openness to learning new skills as the workplace evolves

🏖️ Benefits

• CVS Health bonus, commission or short-term incentive program in addition to base pay • Medical coverage • Dental coverage • Vision coverage • Paid time off • Retirement savings options • Wellness programs • Other resources supporting physical, emotional, and financial well-being • Remote work opportunity • Company-provided equipment, including keyboard, monitor, computer, and headset

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