Utilization Management Nurse Consultant

Job not on LinkedIn

🔥 16 hours ago

🌪️ Kansas – Remote

🌪️ Kansas – Remote

💵 $26 - $68 / hour

⏰ Full Time

🟢 Junior

🟡 Mid-level

💼 Consultant

👻 Ghost score 0%

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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 make coverage recommendations • Collaborate with physicians, providers, and care teams to coordinate treatment and services • Identify opportunities to improve quality, outcomes, and healthcare resource utilization • Support members through referrals to additional programs and services when appropriate • Contribute to a fast-paced, team-oriented environment focused on delivering exceptional care • Influence care decisions and improve member outcomes

🎯 Requirements

• Active, unrestricted RN license in your state of residence • 2+ years of recent RN experience in adult acute care or critical care • Associate Degree in Nursing required • Experience in Medical-Surgical (Med-Surg) nursing or another specialty area preferred • Prior Utilization Management or Managed Care experience preferred • Strong clinical assessment, critical thinking, and communication skills • Ability to navigate multiple computer systems and manage competing priorities • Residence in the Central Time Zone or Mountain Time Zone preferred • Ability to work evenings, weekends, and holidays as schedules may include them • 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 • Ability to work within the state and city where currently residing • Ability to provide workspace furniture for extended desk-based work • Ability to use multiple monitors and applications simultaneously • Ability to use 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 and password security practices 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

🏖️ Benefits

• Medical coverage • Dental coverage • Vision coverage • Paid time off • Retirement savings options • Wellness programs • Other resources supporting physical, emotional, and financial well-being • Company-provided equipment (keyboard, monitor, computer, headset, etc.) • Opportunities for professional growth • CVS Health bonus, commission or short-term incentive program in addition to base pay

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