Remote Utilization Management Nurse; Precertification

CVS Health is seeking a remote Utilization Management Nurse Consultant (Clinical Precertification RN) to evaluate medical necessity for Medicare beneficiaries. You will review cases, determine coverage using guidelines, and coordinate with care teams to ensure appropriate treatment within a fast-paced, 24/7 operating environment.

The role emphasizes strong clinical judgment, collaboration, and the ability to work a weekday schedule from home, with a focus on quality, safety, and patient outcomes.

This Full Time opportunity is for the Remote Utilization Management Nurse (Precertification) role at CVS Health.

Please review the full job details above before applying.

If your experience matches this role, we encourage you to apply.

All applications are reviewed carefully by our team.

This is a Full Time role.

The position is based in ME, United States.

This opportunity is part of our work in Bio & Pharmacology & Health, Consulting.