Utilization Management Nurse Consultant

The Utilization Management Nurse Consultant at CVS Health is responsible for assessing, planning, implementing, and coordinating healthcare services for members. This role is ideal for experienced nurses looking to contribute to a collaborative healthcare environment.

• Pay: $29.10 - $62.32/hour
• Location: Remote, CO
• Schedule: Full-time, Monday through Friday, 9:00am - 5:30pm EST or CST with occasional holiday rotation

• Utilize clinical experience to assess and evaluate healthcare services for members.
• Gather clinical information and apply clinical criteria to render coverage determinations.
• Communicate with providers to facilitate care and treatment.
• Identify members for referral opportunities to integrate with other services and programs.
• Promote quality effectiveness of healthcare services and benefit utilization.
• Consult with internal and external constituents on utilization management functions.

• Associates degree required, BSN preferred

• 3+ years of experience as a Registered Nurse
• 1+ years of Med/Surg experience
• 1+ years of experience with Microsoft Office applications

• Active current and unrestricted RN licensure in state of residence required

• Medical, dental, and vision coverage
• Paid time off
• Retirement savings options
• Wellness programs and other resources

CVS Health is a leading healthcare provider committed to delivering exceptional patient care. They focus on fostering a workplace where every colleague feels valued and belongs, reflecting the diverse communities they serve.