Utilization Management Nurse Consultant

Clinical Careers Page(25 days ago)

RemoteFull TimeMedior$58,200 - $124,640Clinical

About this role

A Utilization Management Nurse Consultant at CVS Health works remotely to review clinical records and apply utilization/benefit management criteria to ensure members receive appropriate care. The role focuses on coordinating care across providers and facilities, supporting discharge planning, and ensuring adherence to regulated turn-around times.

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Required Skills

Utilization Review
Case Management
Clinical Documentation
Discharge Planning
Telephonic Communication
Microsoft Office
Customer Service
Acute Care

Qualifications

RN License
Associate's Degree
BSN (Preferred)

About Clinical Careers Page

cvshealth.com

CVS Health is America's leading health solutions company, providing integrated services across retail pharmacy (CVS Pharmacy), pharmacy benefits management (CVS Caremark), and health insurance (Aetna). The company offers pharmacy services, health plans, clinical care (including MinuteClinic), and health-and-wellness programs for consumers, employers, and government payers. By combining a large national retail footprint with claims processing, care management, and clinical services, CVS Health aims to coordinate care, lower costs, and improve health outcomes. Businesses and consumers use its solutions for medication management, plan administration, and in-person and virtual care.

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