Utilization Management Nurse Consultant

Job not on LinkedIn

🔥 22 minutes ago

🌽 Illinois – Remote

🌽 Illinois – Remote

💵 $26 - $68 / 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.

Apply Now

Find Similar Remote Jobs

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

• Assess, plan, implement, coordinate, monitor, and evaluate options to facilitate appropriate healthcare services and benefits for members • Gather clinical information and apply clinical criteria, guidelines, policies, procedures, and clinical judgment to render coverage determinations or recommendations • Communicate with providers and other parties to facilitate care and treatment • Identify members for referral opportunities involving other products, services, or programs • Identify opportunities to promote healthcare services quality and effective benefit utilization • Consult with and provide expertise to internal and external constituents in coordinating and administering utilization and benefit management • Work in a typical office environment with productivity and quality expectations • Perform close inspection of handwritten and computer-generated documents and PC monitor content • Sit for extended periods, talk on the telephone, and type on a computer • Multitask, prioritize, and adapt to a fast-paced changing environment

🎯 Requirements

• Must reside in Central Time, Mountain Time, or Pacific Time zones • Must have active, current and unrestricted Registered Nurse (RN) licensure in the state of residence • 2+ years of experience as a Registered Nurse in an adult acute care/critical care setting • Availability to work weekends, holidays, and evening hours as required by business needs • Associates Degree in Nursing or Nursing Diploma required • 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 • WiFi and satellite internet are not permitted • Quiet, secure, private designated home workspace compliant with CVS Health and HIPAA guidelines • Must work within the state and city where currently residing • Ability to use multiple monitors and navigate multiple applications • Ability to use email, calendar invites, Teams messaging, and virtual meetings • Experience with Microsoft Office 365 or similar Google Workspace applications • Ability to access secure systems such as VPN and EHR portals • Ability to follow computer security practices, manage strong passwords, and identify suspicious emails or links • Ability to troubleshoot common technical issues • Effective verbal and written communication skills • Preferred: 2+ years of clinical experience in med surg or a specialty area • Preferred: managed care experience, especially Utilization Management

🏖️ Benefits

• Medical coverage • Dental coverage • Vision coverage • Paid time off • Retirement savings options • Wellness programs • Other resources supporting physical, emotional, and financial well-being • CVS Health bonus, commission or short-term incentive program eligibility • Company-provided equipment (keyboard, monitor, computer, headset, etc.) • Remote work from home • Comprehensive benefits package for eligible full-time colleagues

📊 Check your resume score for this job

Improve your chances of getting an interview by checking your resume score before you apply.

Upload Resume