Utilization Management Nurse Consultant

Registered Nurse (RN) – Utilization Management (24/7 Operations)

Step away from bedside care and make a system-wide impact. Join our Utilization Management team and help ensure members receive the right care at the right time.

What You'll Do

• Review clinical information and apply guidelines to support coverage decisions
• Collaborate with providers and care teams to coordinate appropriate treatment
• Identify opportunities to improve care quality and resource utilization
• Connect members to programs and services that support better outcomes
• Provide clinical expertise across internal and external teams

What You Bring - REQUIRED

• Active, unrestricted RN license in your state of residence
• 2+ years of adult acute care or critical care experience
• Strong clinical judgment, communication, and organizational skills
• Ability to multitask and thrive in a fast-paced, technology-driven environment

Preferred

• Experience in Med-Surg or a specialty area
• Managed Care or Utilization Management experience
• Located in Central, Mountain, or Pacific time zones

Schedule & Work Environment

• 24/7 operations, including evenings, weekends, and holidays
• Sedentary, computer-based role with high attention to detail and productivity expectations

Education

• Associate's Degree required
• BSN preferred

Anticipated Weekly Hours

40

Time Type

Full time

Pay Range

The typical pay range for this role is:

$29.10 - $62.32

This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. 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.

Great benefits for great people

We take pride in offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families. 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. The benefits for this position include medical, dental, and vision coverage, paid time off, retirement savings options, wellness programs, and other resources, based on eligibility.