Utilization Management Nurse ConsultantCVS Health • Rutherford, New Jersey, United States
Utilization Management Nurse Consultant
CVS Health
- Rutherford, New Jersey, United States
- Rutherford, New Jersey, United States
À propos
Review clinical records to assess medical necessity and appropriate benefit utilization
Apply clinical judgment and guidelines to make coverage recommendations
Collaborate with providers and care teams to support effective treatment and discharge planning
Coordinate and document utilization management activities across the care continuum
Identify opportunities to improve quality, efficiency, and member outcomes
Support referrals to additional programs and services when appropriate
What You Bring - REQUIRED
Active, unrestricted RN license (state of residence)
3+ years of clinical RN experience (all specialties welcome)
Strong communication and critical thinking skills
Proficiency with Microsoft Office and navigating multiple systems
Ability to manage priorities in a fast-paced, collaborative environment
Associates Degree in Nursing
Preferred
Experience in Utilization Review or Managed Care
BSN
Strong telephonic communication and multitasking skills
Why Join Us?
Expand your clinical impact in a non-bedside role
Work with a collaborative, mission-driven team
Apply your expertise to improve care quality and outcomes on a broader scale
Anticipated Weekly Hours 40 Time Type Full time Pay Range The typical pay range for this role is: $26.01 - $68.55 This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above. Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong. Great benefits for great people We take pride in offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families. This full‑time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial well‑being of colleagues and their families. The benefits for this position include medical, dental, and vision coverage, paid time off, retirement savings options, wellness programs, and other resources, based on eligibility. Additional details about available benefits are provided during the application process and on Benefits Moments (https://learn.bswift.com/cvshealth-mainland) . We anticipate the application window for this opening will close on: 06/09/2026 Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws. CVS Health is an equal opportunity/affirmative action employer, including Disability/Protected Veteran — committed to diversity in the workplace.
Compétences linguistiques
- English
Avis aux utilisateurs
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