Utilization Management Nurse Consultant - Weekends 10-Hour Shifts
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. Remote Utilization Management RN (Prior Authorization) Full-Time | Remote | Weekend Schedule We’re seeking an experienced Registered Nurse (RN) to join our Utilization Management team in a fully remote role. This position is ideal for nurses who enjoy applying clinical judgment, working collaboratively with providers, and influencing quality healthcare decisions—without bedside demands.
Requirements
- Active, unrestricted Compact RN license in the state of residence, OR Texas RN license
- 3+ years of clinical nursing experience
- Proficiency with Microsoft Office and navigating multiple systems
- Strong critical thinking, communication, and multitasking skills
- Comfort working in a fast-paced, remote, desk-based environment
- Associate’s degree in nursing required
Nice To Haves
- Prior Authorization or Utilization Management experience
- BSN preferred
Responsibilities
- Review clinical documentation and apply evidence-based criteria to authorize services or escalate cases to a Medical Director
- Communicate with providers to gather information and facilitate timely care
- Support appropriate utilization of healthcare benefits across the continuum of care
- Identify opportunities for referrals, care coordination, and quality improvement
- Collaborate with internal and external partners in utilization and benefit management
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
Number of Employees
5,001-10,000 employees
