Utilization Management Nurse Consultant
About The Position
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. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. 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.
Requirements
- 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
Nice To Haves
- Experience in Med-Surg or a specialty area
- Managed Care or Utilization Management experience
- Located in Central, Mountain, or Pacific time zones
Responsibilities
- 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
Benefits
- medical
- dental
- vision coverage
- paid time off
- retirement savings options
- wellness programs
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
Associate degree
