Utilization Management Nurse Consultant – Weekends, 4-10 Hour Shifts

CVS Health

Utilization Management Nurse Consultant reviewing clinical information and coordinating treatment plans. Collaborating with providers to enhance quality and efficiency for members' outcomes in a remote capacity.

Posted 5/29/2026full-timeRemote • Idaho, Mississippi, North Carolina, Texas • 🇺🇸 United StatesMid-LevelSenior💰 $26 - $62 per hourWebsite

About the role

Key responsibilities & impact

Review and assess clinical information to support coverage determinations
Apply clinical guidelines, policies, and sound judgment across the care continuum
Collaborate with providers and care teams to coordinate treatment plans
Identify opportunities to enhance quality, efficiency, and member outcomes
Refer members to additional programs and services as appropriate
Serve as a clinical resource within utilization/benefit management

Requirements

What you’ll need

Active, unrestricted RN license in state of residence
3+ years of RN experience
1+ year Med/Surg experience
Proficiency with Microsoft Office (Outlook, Teams, Excel)
Willingness to work required schedule post-training
Prior Authorization or Utilization Management experience preferred
Managed care experience preferred
MedCompass experience preferred
Ambulatory surgery background preferred
BSN preferred (Associate’s required)

Benefits

Comp & perks

medical, dental, and vision coverage
paid time off
retirement savings options
wellness programs
other resources, based on eligibility

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills & Tools

RN licenseMed/Surg experiencePrior Authorization experienceUtilization Management experienceManaged care experienceAmbulatory surgery backgroundBSNclinical guidelines applicationtreatment plan coordinationquality enhancement

Soft Skills

collaborationjudgmentcommunicationproblem-solvingorganizational skills

Certifications

Active RN license