Utilization Management Nurse Consultant

Job not on LinkedIn

🔥 12 minutes ago

🐊 Florida – Remote

🐊 Florida – 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.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

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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 and assess clinical information to support coverage determinations and recommendations • Apply evidence-based clinical criteria, policies, and professional judgment across the continuum of care • Collaborate with providers and interdisciplinary teams to coordinate care and promote positive member outcomes • Identify opportunities for quality improvement, care integration, and effective benefit utilization • Serve as a clinical resource for internal and external stakeholders • Work remotely while leveraging clinical expertise to influence quality outcomes and healthcare resource utilization

🎯 Requirements

• Active, unrestricted RN license in your state of residence • Minimum 2 years of RN experience in an adult acute care or critical care setting • Associates degree in nursing • 2+ years of Med-Surg or specialty clinical experience (preferred) • Utilization Management and/or Managed Care experience (preferred) • Strong communication, critical thinking, and computer navigation skills (preferred) • Ability to thrive in a fast-paced environment and manage multiple priorities (preferred) • Candidates located in the Eastern Time Zone are strongly preferred • BSN preferred • Direct/hardwired internet connection to a modem/router within 7 feet of the computer, with minimum 25 Mbps download and 3 Mbps upload; WiFi and satellite internet are not permitted • Quiet, secure, private designated home workspace compliant with CVS Health and HIPAA guidelines • Ability to work within the state and city where the candidate currently lives • Ability to provide workspace furniture, such as a desk or standing desk • Comfort setting up and using multiple monitors and navigating multiple applications • Ability to use email, calendar invites, Teams messaging, and virtual meetings • Experience with Microsoft Office 365 applications or similar Google Workspace applications • Ability to log in to secure systems such as VPN and EHR portals, lock screens, manage strong passwords, and recognize suspicious emails or links • Ability to troubleshoot common technical issues and contact IT when needed • Openness to learning new skills as the workplace evolves • Availability for schedules that may include evenings, weekends, and holidays in a 24/7 operation

🏖️ Benefits

• 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 • Company-provided equipment (keyboard, monitor, computer, headset, etc.) • CVS Health bonus, commission or short-term incentive program in addition to base pay

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