CVS Health is seeking an experienced Utilization Management RN to review prior authorization requests across multiple specialties and determine medical necessity using InterQual/MCG guidelines. The role emphasizes collaboration with providers and care teams, strict compliance with health plan policies, and managing a high-volume caseload from a remote home office.
The ideal candidate holds an active multi-state RN license, 3+ years of clinical nursing, and 2+ years in utilization management or
#J-18808-LjbffrRemote RN: Utilization Management & Prior Authorization in workfromhome at Unknown Company
This position is listed as full time and able to be worked remotely.