Utilization Management Nurse Consultant

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

Use your clinical expertise to make a broader impact. Join our Utilization Management team and help ensure members receive the right care, at the right time, in the most effective way.

What You'll Do

• Review clinical information and apply guidelines to support coverage determinations
• Collaborate with providers and care teams to coordinate appropriate treatment plans
• Identify opportunities to improve quality, outcomes, and resource utilization
• Connect members to programs and services that enhance care delivery
• Provide clinical expertise to internal and external stakeholders

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 multitasking skills
• Ability to thrive in a fast-paced, technology-driven environment
• Flexibility, adaptable to change

Preferred

• Experience in Med-Surg or a specialty area
• Managed Care or Utilization Management experience
• Located in the Central Time Zone

Schedule & Environment

• 24/7 operations (includes 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:

$26.01 - $56.14

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.

Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.

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.

Additional details about available benefits are provided during the application process and on Benefits Moments.