Remote RN Utilization Management Nurse (Weekend Shifts)

CVS Health; San Francisco (CA); Remote; USD 36,000 - 86,000; Full time

Benefits offered by this job

Medical, dental, and vision coverage

Paid time off

Retirement savings options

Wellness programs

Job summary

CVS Health is seeking a Medicare Precertification Utilization Management Nurse Consultant (RN) for remote weekend coverage. The role focuses on ensuring appropriate care determinations, applying guidelines, and coordinating with care teams.

Hours include 40 hours weekly with a 4-day training period and a Friday–Monday 10-hour weekend shift schedule. The position requires an active RN license, 3+ years of RN experience, and proficiency with Microsoft Office.

Qualifications

• Licensed RN in your state
• 3+ years of RN experience
• Proficient with Microsoft Office (Outlook, Teams, Excel)
• BSN preferred or Associate’s required

Responsibilities

• Review clinical information to support coverage determinations
• Apply clinical guidelines and policies with sound judgment
• Collaborate with providers to coordinate treatment plans
• Refer members to additional programs and services when appropriate
• Serve as a clinical resource within utilization/benefit management

Skills

RN experience

Detail-oriented

Communication skills

Education

BSN preferred

Associate’s degree required

Tools

Microsoft Office

EHR systems

MedCompass experience

Job description

CVS Health is seeking a Medicare Precertification Utilization Management Nurse Consultant (RN) for remote weekend coverage. The role focuses on ensuring appropriate care determinations, applying guidelines, and coordinating with care teams.

Hours include 40 hours weekly with a 4-day training period and a Friday–Monday 10-hour weekend shift schedule. The position requires an active RN license, 3+ years of RN experience, and proficiency with Microsoft Office.