Utilization Management Nurse Consultant

Job not on LinkedIn

🔥 41 minutes ago

🏈 Ohio – Remote

🏈 Ohio – Remote

💵 $29 - $62 / 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 care decisions • Apply clinical guidelines, policies, and nursing judgment across the continuum of care • Collaborate with providers and interdisciplinary teams to coordinate care and treatment plans • Identify opportunities to improve healthcare quality, benefit utilization, and member outcomes • Refer members to appropriate programs and services supporting comprehensive care • Work remotely within the state and city of confirmed residence • Operate effectively across multiple monitors, applications, secure systems, and digital communication tools

🎯 Requirements

• Active, unrestricted RN license in your state of residence • Associate Degree in Nursing required • 2+ years of RN experience in adult acute care or critical care settings • Strong clinical assessment, communication, and multitasking skills • Comfortable working in a fast-paced, technology-driven environment • Must work within the state and city where you currently live • 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 use multiple monitors and navigate multiple applications • Ability to use digital communication channels, including email, calendar invites, Teams messaging, and virtual meetings • Experience with Microsoft Office 365 applications or similar Google Workspace applications • Ability to access secure systems such as VPN and EHR portals • Ability to follow computer security practices, including locking screens, managing strong passwords, and recognizing suspicious emails or links • Ability to resolve common technical issues independently • Flexibility to work evenings, weekends, and holidays in a 24/7 operation • BSN preferred • 2+ years of Med-Surg or specialty clinical experience preferred • Managed Care and/or Utilization Management experience preferred

🏖️ 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 in addition to base pay range • Company-provided equipment (keyboard, monitor, computer, headset, etc.) • Flexible remote work environment

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