{"version":"0.1","company":{"name":"YubHub","url":"https://yubhub.co","jobsUrl":"https://yubhub.co/jobs/city/work-at-home/"},"x-facet":{"type":"city","slug":"work-at-home","display":"Work At Home","count":1},"x-feed-size-limit":100,"x-feed-sort":"enriched_at desc","x-feed-notice":"This feed contains at most 100 jobs (the most recently enriched). For the full corpus, use the paginated /stats/by-facet endpoint or /search.","x-generator":"yubhub-xml-generator","x-rights":"Free to redistribute with attribution: \"Data by YubHub (https://yubhub.co)\"","x-schema":"Each entry in `jobs` follows https://schema.org/JobPosting. YubHub-native raw fields carry `x-` prefix.","jobs":[{"@context":"https://schema.org","@type":"JobPosting","identifier":{"@type":"PropertyValue","name":"YubHub","value":"job_c983c5d5-301"},"title":"Utilization Management Nurse Consultant","description":"<p>We&#39;re building a world of health around every individual , shaping a more connected, convenient and compassionate health experience.</p>\n<p>The Utilization Management Nurse Consultant utilises clinical experience and skills in a collaborative process to assess, plan, implement, coordinate, monitor and evaluate options to facilitate appropriate healthcare services/benefits for members.</p>\n<p><strong>Responsibilities</strong></p>\n<ul>\n<li>Gathers clinical information and applies clinical criteria, guidelines, policies and procedures to render coverage determinations and recommendations along the continuum of care.</li>\n<li>Communicates with providers and other parties to facilitate care and treatment.</li>\n<li>Identifies members for referral opportunities to integrate with other products, services and programmes.</li>\n<li>Identifies opportunities to promote quality effectiveness of Healthcare Services and benefit utilisation.</li>\n<li>Consults and lends expertise to internal and external constituents in the coordination and administration of the utilisation/benefit management function.</li>\n<li>Works in a typical office environment with productivity and quality expectations.</li>\n<li>Performs close inspection of handwritten and computer-generated documents and PC monitors.</li>\n<li>Sedentary work involving periods of sitting, talking and listening.</li>\n<li>Requires sitting for extended periods, talking on the telephone and typing on the computer.</li>\n<li>Ability to multitask, prioritise and adapt to a fast-paced changing environment.</li>\n<li>Proficiency with computer skills, including navigating multiple systems and keyboarding.</li>\n<li>Effective communication skills, both verbal and written.</li>\n</ul>\n<p><strong>Requirements</strong></p>\n<ul>\n<li>2+ years of clinical experience as a Registered Nurse in a hospital setting in adult acute care/critical care setting.</li>\n<li>Active current and unrestricted RN licensure in state of residence.</li>\n</ul>\n<p><strong>Preferred Qualifications</strong></p>\n<ul>\n<li>3+ years of clinical experience in adult med surg or specialty area.</li>\n<li>Managed Care experience preferred, especially Utilisation Management.</li>\n<li>Preference for those residing in CST zone.</li>\n</ul>\n<p><strong>Education</strong></p>\n<ul>\n<li>Associate or Bachelor of Science in Nursing (BSN preferred).</li>\n</ul>\n<p><strong>Work from Home Requirements</strong></p>\n<ul>\n<li>Direct/hardwired internet connection to a modem/router within 7 feet of computer and minimum download speed of 25 Mbps download and 3 Mbps upload.</li>\n<li>Quiet, secure and private designated home virtual work location, free from distractions, tidy and organised, compliant with CVSHealth and HIPAA guidelines.</li>\n<li>Work-from-Home colleagues are required to work within the state and city where they have confirmed they currently live.</li>\n<li>The company will provide equipment (keyboard, monitor, computer, headset, etc.).</li>\n</ul>\n<p><strong>Technical and Logistical Requirements</strong></p>\n<ul>\n<li>Device &amp; System Navigation: Comfortable setting up and using multiple monitors and navigating multiple applications simultaneously.</li>\n<li>Communication Tools: Ability to communicate on digital channels such as via email, calendar invites, Teams messaging, and virtual meetings.</li>\n<li>Collaboration &amp; Scheduling: Experience with Microsoft Office 365 (Teams, Outlook, Word, Excel, PowerPoint) applications or similar (Google Workspace).</li>\n<li>Systems Access &amp; Security: Ability to Log in to secure systems (e.g., VPN, EHR portal), lock a computer screen when unattended, manage strong passwords, and recognise suspicious emails or links.</li>\n<li>Troubleshooting &amp; Support: Ability to resolve common technical issues independently.</li>\n<li>Future Growth: Openness to learning new skills in the future as the workplace environment evolves.</li>\n</ul>\n<p><strong>Benefits</strong> 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.</p>\n<p style=\"margin-top:24px;font-size:13px;color:#666;\">Job Data by <a href=\"https://yubhub.co\">YubHub</a>.</p>","url":"https://cvshealth.wd1.myworkdayjobs.com/en-US/CVS_Health_Careers/job/Work-At-Home-Alabama/Utilization-Management-Nurse-Consultant--Remote-_R1050984","directApply":true,"hiringOrganization":{"@type":"Organization","name":"CVS Health","sameAs":"https://cvshealth.com","logo":"https://logos.yubhub.co/cvshealth.com.png"},"x-apply-url":"https://cvshealth.wd1.myworkdayjobs.com/en-US/CVS_Health_Careers/job/Work-At-Home-Alabama/Utilization-Management-Nurse-Consultant--Remote-_R1050984","x-work-arrangement":"remote","x-experience-level":"senior","x-job-type":"full-time","x-salary-range":"$26.01 - $56.14","x-skills-required":["Registered Nurse","Clinical Experience","Utilisation Management","Microsoft Office 365"],"x-skills-preferred":["Managed Care","Adult Med Surg","Specialty Area"],"x-benefits":["pension","health_insurance","dental","paid_leave","bonus"],"x-licences":["RN licence"],"x-visa-sponsorship":"unknown","x-visa-sponsorship-text":null,"x-work-authorisation":"unknown","x-work-authorisation-text":null,"datePosted":"2026-11-05T00:00:00.000Z","jobLocation":{"@type":"Place","address":{"@type":"PostalAddress","addressLocality":"Work At Home, Alabama"}},"jobLocationType":"TELECOMMUTE","employmentType":"FULL_TIME","occupationalCategory":"Healthcare","industry":"Healthcare","skills":"Registered Nurse, Clinical Experience, Utilisation Management, Microsoft Office 365, Managed Care, Adult Med Surg, Specialty Area"}]}