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. Bring your clinical expertise beyond the bedside and help drive better healthcare outcomes. We’re looking for a skilled RN to join our Utilization Management team, ensuring members receive appropriate, high-quality care across the continuum.
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 multitasking skills
- Comfort working in a fast-paced, technology-driven environment
- Associate’s Degree required
Nice To Haves
- Experience in Med-Surg or a specialty area
- Managed Care or Utilization Management experience
- Reside in Eastern or Central time zones
- BSN preferred
Responsibilities
- Review clinical documentation and apply guidelines to support coverage decisions
- Collaborate with providers and care teams to coordinate appropriate treatment
- Identify opportunities to improve quality, outcomes, and resource utilization
- Connect members to programs and services that support holistic care
- Provide clinical expertise to internal and external stakeholders
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
