Utilization Management Nurse Consultant – EST

Job not on LinkedIn

🔥 7 minutes ago

🦌 Connecticut, Florida, +8 more states – Remote

🦌 Connecticut – Remote 🐊 Florida – Remote 🦞 Maine – Remote 🗻 New Hampshire – Remote 🏖️ New Jersey – Remote 🗽 New York – Remote 🏈 Ohio – Remote 🦀 Maryland – Remote 🍂 Massachusetts – Remote 🌴 South Carolina – Remote

💵 $26 - $56 / hour

⏰ Full Time

🟢 Junior

🟡 Mid-level

💼 Consultant

👻 Ghost score 0%

What it means: how likely this posting is sitting open without active hiring.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

Set Up Email Alert For New Jobs

📊 Check your resume score for this job

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

Upload Resume

CVS Health

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 1963

🏥 Healthcare

⚕️ Healthcare Insurance

🛒 Retail

Healthcare • Healthcare Insurance • Retail

CVS Health is a leading American healthcare company dedicated to improving health access and affordability. The company focuses on a comprehensive approach that includes health services, health insurance, and pharmacy benefits management. Through its subsidiaries, such as Aetna and CVS Caremark, CVS Health offers a range of services that facilitate wellness, condition management, and affordable prescription drug coverage. CVS Health operates neighborhood pharmacies, provides mail-order pharmacy services, and manages specialty medication programs, aiming to make healthcare convenient and accessible for everyone. Driven by a mission to connect people with essential care services, CVS Health is committed to fostering healthier communities and supporting the wellbeing of all individuals.

📋 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 service quality, effectiveness, and benefit utilization • Consult with internal and external constituents regarding utilization and benefit management coordination and administration • Work in a typical office environment with productivity and quality expectations while working remotely • Perform close inspection of handwritten and computer-generated documents and PC monitors • Work sedentary hours involving extended sitting, telephone communication, and computer typing

🎯 Requirements

• Candidate must reside in EST zones • Active and unrestricted Registered Nurse (RN) license in the state of residence • 2+ years of experience as a Registered Nurse in adult acute care/critical care setting • Availability to work weekends, holidays, and evening hours as required • Associates Degree in Nursing (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 • Quiet, secure, private designated home workspace compliant with CVS Health and HIPAA guidelines • Ability to work within the state and city where currently residing • Computer proficiency, including multiple systems and keyboarding • Effective verbal and written communication skills • Ability to inspect handwritten and computer-generated documents and PC monitors closely • Ability to sit for extended periods, talk on the telephone, type, multitask, prioritize, and adapt to a fast-paced changing environment • Comfort setting up and using multiple monitors and navigating multiple applications • Ability to use email, calendar invites, Teams messaging, and virtual meetings • Experience with Microsoft Office 365 applications or similar Google Workspace tools • Ability to access secure systems such as VPN and EHR portals, secure devices, manage strong passwords, and recognize suspicious emails or links • Ability to troubleshoot common technical issues independently

🏖️ Benefits

• CVS Health bonus, commission or short-term incentive program in addition to base pay • Medical coverage • Dental coverage • Vision coverage • Paid time off • Retirement savings options • Wellness programs • Other resources supporting physical, emotional, and financial well-being • Remote work from home • Company-provided equipment including keyboard, monitor, computer, and headset