Utilization Management Nurse Consultant

Clinical Careers Page(26 days ago)

RemoteFull TimeMedior$58,200 - $124,640Utilization Management

About this role

The Utilization Management Nurse Consultant is a licensed registered nurse who applies clinical judgment to support utilization/benefit management programs and ensure members receive appropriate, timely care. This remote role focuses on reviewing clinical records, supporting care coordination, and ensuring regulatory and policy compliance within CVS Health’s utilization management function.

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Required Skills

Utilization Management
Clinical Assessment
Care Coordination
Medical Review
Telephonic Communication
Documentation
Decision Making
Medical Terminology
Microsoft Office

Qualifications

Associate Degree in Nursing
BSN (Preferred)
RN License (Active, Unrestricted)
LCSW (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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