Utilization Management Nurse Consultant

We’re building a world of health around every individual – shaping a more connected, convenient, and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable, and prioritize safety and quality in everything we do. Location: Remote (CST/MST preferred). Schedule: Monday – Friday 8:00am to 5:00pm in your time zone. Utilization Management is a 24/7 operation – schedules include evenings, weekends, and holidays. What You’ll Do Review clinical information and apply evidence‑based guidelines to make coverage determinations Collaborate with providers and care teams to coordinate services and support treatment plans Identify opportunities to improve care quality, efficiency, and member outcomes Connect members to additional programs and resources Serve as a clinical resource for internal and external partners What You Bring Active, unrestricted RN license in state of residence (required) 2+ years of adult acute or critical care experience Strong clinical judgment, communication, and multitasking skills Comfort working in a fast‑paced, technology‑driven environment Associate’s Degree in Nursing (preferred) Med‑Surg or specialty clinical experience (preferred) Managed care or Utilization Management experience (preferred) BSN (preferred) Located in CST or MST Remote, sedentary role with high‑quality and productivity expectations Regular computer and phone use; ability to navigate multiple systems Why Join Us? Be part of a collaborative team that improves healthcare outcomes while expanding your clinical impact in a dynamic, non‑bedside role. Anticipated Weekly Hours 40 hours per week. Full time. Pay Range The typical pay range for this role is $26.01 – $56.14 per hour or an equivalent annual base salary. 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. Benefits 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. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws. #J-18808-Ljbffr