Utilization Management Nurse Consultant – Weekend

CVS Health

Utilization Management Nurse Consultant responsible for assessing, planning, and coordinating healthcare services. Working remotely to facilitate care and treatment for members across multiple states.

Posted 6/9/2026full-timeRemote • Florida, Idaho, Texas • 🇺🇸 United StatesMid-LevelSenior💰 $29 - $62 per hourWebsite

About the role

Key responsibilities & impact

Gather clinical information and apply appropriate clinical criteria, guidelines, policies, and procedures
Communicate with providers and other parties to facilitate care and treatment
Identify members for referral opportunities to integrate with other products, services, or benefit programs
Identify opportunities to promote quality and effectiveness of healthcare services and benefit utilization
Consult and lend expertise to internal and external constituents in coordination and administration of utilization management function
Meet productivity and quality expectations as established by UMNC

Requirements

What you’ll need

Registered Nurse
Diploma RN acceptable; Associate degree / BSN preferred
3+ years of experience as a Registered Nurse
1+ years of clinical experience in acute or post-acute setting
1+ years of Utilization Management / Care Management Experience
Active current and unrestricted RN licensure in state of residence

Benefits

Comp & perks

Medical, dental, and vision coverage
Paid time off
Retirement savings options
Wellness programs

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills & Tools

clinical criteriaguidelinespoliciesproceduresutilization managementcare managementacute carepost-acute care

Soft Skills

communicationcoordinationadministrationproductivityquality improvement

Certifications

Registered NurseRN licensure