Utilization Management Nurse Consultant – Weekends, 4-10 Hour Shifts

Job not on LinkedIn

🔥 0 minutes ago

🏈 Alabama, Arizona, +17 more states – Remote

🏈 Alabama – Remote 🌵 Arizona – Remote 🏄 California – Remote ⛰️ Colorado – Remote 🥔 Idaho – Remote 🌽 Illinois – Remote 🐎 Kentucky – Remote ⚜️ Louisiana – Remote 🦞 Maine – Remote 🎰 Nevada – Remote 🌲 North Carolina – Remote 🌪️ Oklahoma – Remote 🌲 Oregon – Remote ❄️ Minnesota – Remote 🎸 Mississippi – Remote 🏰 Missouri – Remote 🤠 Texas – Remote 🍁 Vermont – Remote ☕ Washington – Remote

💵 $26 - $62 / hour

⏰ Full Time

🟡 Mid-level

🟠 Senior

💼 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.

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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

• Review and assess clinical information to support coverage determinations • Apply clinical guidelines, policies, and sound judgment across the care continuum • Collaborate with providers and care teams to coordinate treatment plans • Identify opportunities to enhance quality, efficiency, and member outcomes • Refer members to additional programs and services as appropriate • Serve as a clinical resource within utilization and benefit management • Complete Monday–Friday training from 8:30 AM–5:00 PM EST • Work a four-day weekend schedule from Friday through Monday with 10-hour shifts after training • Work evening hours and occasional holidays within a 24/7 operation

🎯 Requirements

• Active, unrestricted RN license in state of residence • 3+ years of RN experience • 1+ year of Med/Surg experience • Proficiency with Microsoft Office (Outlook, Teams, Excel) • Willingness to work the required schedule post-training • Prior Authorization or Utilization Management experience preferred • Managed care experience preferred • MedCompass experience preferred • Ambulatory surgery background preferred • Associate’s degree required; BSN preferred • Direct/hardwired internet connection to a modem/router within 7 feet of the computer, or ability to obtain one • Minimum internet speed of 25 Mbps download and 3 Mbps upload • Quiet, secure, private designated home virtual work location compliant with CVS Health and HIPAA guidelines • Must work within the state and city where currently living • Ability to set up and use multiple monitors and navigate multiple applications simultaneously • Ability to use 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 troubleshoot common technical issues and contact IT when needed

🏖️ 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 • Company-provided equipment (keyboard, monitor, computer, headset, etc.) • Professional growth opportunities