Utilization Management Nurse Consultant

Job not on LinkedIn

🔥 2 hours ago

🤠 Texas – Remote

🤠 Texas – Remote

💵 $29 - $62 / hour

⏱ Part 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

• 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, and programs • Identify opportunities to promote healthcare service quality and effective benefit utilization • Consult with internal and external constituents on utilization and benefit management coordination and administration • Work in a typical office environment with productivity and quality expectations • Perform close inspection of handwritten and computer-generated documents and PC monitors • Sit for extended periods, talk on the telephone, type, multitask, prioritize, and adapt to a fast-paced changing environment

🎯 Requirements

• 2+ years of experience as a Registered Nurse in an adult acute care/critical care setting • Active, current, and unrestricted RN licensure in the state of residence • Must reside in EST or CST • Ability to work weekends, holidays, and evening hours in a 24/7 operation • Comfortable setting up and using multiple monitors and navigating multiple applications simultaneously • Ability to communicate via email, calendar invites, Teams messaging, and virtual meetings • Experience with Microsoft Office 365 (Teams, Outlook, Word, Excel, PowerPoint) or similar Google Workspace applications • Ability to log in to secure systems such as VPN and EHR portals • Ability to maintain computer security, including locking screens, managing strong passwords, and recognizing suspicious emails or links • Ability to resolve common technical issues independently and contact IT when needed • Direct/hardwired internet connection to a modem/router within 7 feet of the computer • Minimum internet speed of 50 Mbps download and 5 Mbps upload • Quiet, secure, private, and HIPAA-compliant designated home workspace • Must work within the state and city where currently living • Must provide own workspace furniture • 2+ years of clinical experience in med surg or a specialty area • Associates Degree required • Effective verbal and written communication skills • Computer proficiency, including keyboarding and navigating multiple systems

🏖️ Benefits

• Dental benefits • Vision benefits • Wellness resources • Employee discounts • Access to certain voluntary benefits • Other programs supporting physical, emotional, and financial well-being • Company-provided equipment (keyboard, monitor, computer, headset, etc.) • Remote work from home

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