Remote Utilization Management Nurse Consultant

CVS Health Corporation; Little Rock (AR); Remote; USD 54,000 - 117,000; Full time

Job summary

CVS Health Corporation is seeking a Utilization Management Nurse Consultant in the United States to apply clinical judgment and coordinate care across the continuum for members. This role supports a 24/7 operation with weekend and evening hours and requires strong communication with providers and teams.

You will gather information, apply applicable criteria, and promote quality and efficiency in benefit utilization while collaborating with internal and external stakeholders.

Qualifications

• 2+ years of clinical RN experience in adult acute/critical care.
• Active RN license in home state.
• Knowledge of utilization management processes and guidelines.

Responsibilities

• Gathers clinical information and applies criteria to render coverage decisions.
• Communicates with providers and other parties to coordinate care.
• Identifies referral opportunities to integrate with other programs.
• Lends expertise in utilization/benefit management across stakeholders.

Skills

RN

Clinical experience

Communication skills

Team collaboration

Education

BSN preferred

Job description

CVS Health Corporation is seeking a Utilization Management Nurse Consultant in the United States to apply clinical judgment and coordinate care across the continuum for members. This role supports a 24/7 operation with weekend and evening hours and requires strong communication with providers and teams.

You will gather information, apply applicable criteria, and promote quality and efficiency in benefit utilization while collaborating with internal and external stakeholders.