Utilization Management Nurse Consultant

Job not on LinkedIn

🔥 36 minutes ago

🇺🇸 United States – Remote

💵 $26 - $56 / 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 clinical documentation and apply evidence-based criteria, policies, and clinical judgment to support coverage determinations • Assess, coordinate, monitor, and evaluate healthcare services across the continuum of care • Collaborate with providers and care teams to facilitate appropriate treatment plans and care coordination • Identify opportunities to improve healthcare quality, effectiveness, and benefit utilization • Connect members to additional programs and resources supporting positive health outcomes • Serve as a clinical resource and consultant to internal and external stakeholders • Work in a computer-based role with productivity and quality expectations • Frequently collaborate with providers, members, and interdisciplinary teams

🎯 Requirements

• Active, unrestricted RN license in your state of residence • 2+ years of adult acute care and/or critical care nursing experience • Strong clinical assessment, critical thinking, and communication skills • Ability to manage multiple priorities in a fast-paced, technology-driven environment • Proficiency navigating multiple computer systems • Associate Degree in Nursing required • Ability to work evenings, weekends, and holidays as part of 24/7 operations • 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 living • 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 applications • Ability to access secure systems such as VPN and EHR portals • Ability to follow computer security practices, including screen locking, strong passwords, and recognizing suspicious emails or links • Ability to resolve common technical issues independently 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.) • CVS Health bonus, commission or short-term incentive program eligibility • Remote work from home

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