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Registered Nurse (RN) – Utilization Management at CVS Health - ApplyBlast

Registered Nurse (RN) – Utilization Management

CVS Health

2 months ago

3.2 on Glassdoor

Remote

Full Time

Junior

0 applicants

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About this role

The role involves a registered nurse providing clinical review and assessment of medical necessity for a 24/7 utilization management operation, coordinating care with providers and internal teams, and serving as a clinical resource to improve healthcare quality and benefit utilization. The position is remote, full‑time, and requires adherence to work‑from‑home technical and security standards.

Responsibilities

Review clinical information to support coverage determinations
Collaborate with providers and internal partners to coordinate care
Identify opportunities to improve healthcare quality and utilization

Skills

Qualifications

Active RN licenseAssociate Degree in NursingBSN

About CVS Health

cvshealth.com

Headquarters

Woonsocket, Rhode Island, United States

Company Size

10001+ employees

Founded

1963

View Profile

CVS Health is America's leading health solutions company, providing integrated services across retail pharmacy (CVS Pharmacy), pharmacy benefits management (CVS Caremark), and health insurance (Aetna). The company offers pharmacy services, health plans, clinical care (including MinuteClinic), and health-and-wellness programs for consumers, employers, and government payers. By combining a large national retail footprint with claims processing, care management, and clinical services, CVS Health aims to coordinate care, lower costs, and improve health outcomes. Businesses and consumers use its solutions for medication management, plan administration, and in-person and virtual care.