Utilization Management Nurse Consultant
Listed on 2026-07-31
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Nursing
RN Nurse
Utilization Management Nurse (RN) – 24/7 Operations
Location: Remote (Preference for CST/MT time zones)
Schedule: Includes evenings, weekends, and holidays. Remote, sedentary role with frequent computer and phone use.
Are you a detail-oriented RN with a passion for improving patient outcomes and healthcare efficiency? Join our Utilization Management team and play a key role in ensuring members receive the right care at the right time.
What You’ll Do- Review clinical information and apply guidelines to make coverage determinations across the care continuum.
- Collaborate with providers and internal teams to coordinate care and support treatment plans.
- Identify opportunities to enhance quality, efficiency, and member outcomes.
- Refer members to appropriate programs, services, and resources.
- Serve as a clinical expert in utilization and benefit management.
Required
- Active, unrestricted RN license in your state of residence.
- 2+ years of recent experience in adult acute or critical care.
- Strong clinical judgment, communication, and multitasking skills.
- Comfort working in a fast-paced, technology-driven environment.
- Associate’s Degree in Nursing.
- Experience in Med‑Surg or a specialty clinical area.
- Managed care or Utilization Management experience.
- Bachelor of Science in Nursing (BSN).
- Residence in CST or MT time zone.
Pay Range
:
The typical pay range for this role is $26.01 – $56.14 per hour. 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.
Benefits
:
Comprehensive benefits package including medical, dental, and vision coverage, paid time off, retirement savings options, wellness programs, and other resources based on eligibility. Details are provided during the application process and on Benefits Moments.
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws.
Application window closes on 07/11/2026.
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