Remote Utilization Management Nurse Consultant

CVS Health Corporation; Philadelphia (Philadelphia County); Remote; USD 40,000 - 86,000; Full time

Job summary

CVS Health is hiring for a Utilization Management RN to support a 24/7 operation with weekend, holiday, and evening requirements. You will assess and coordinate care, apply clinical criteria, and communicate with providers to determine appropriate benefits and services.

This role emphasizes accuracy, collaboration, and the ability to navigate multiple systems while maintaining HIPAA compliance. Ideal candidates have 2+ years as an RN in acute or critical care, an active unrestricted RN license,

Qualifications

• 2+ years of RN experience in adult acute/critical care.
• Active, unrestricted RN licensure in your state.

Skills

Clinical experience

Utilization Management

Med-surg experience

Education

Associates degree

BSN

Job description

CVS Health is hiring for a Utilization Management RN to support a 24/7 operation with weekend, holiday, and evening requirements. You will assess and coordinate care, apply clinical criteria, and communicate with providers to determine appropriate benefits and services.

This role emphasizes accuracy, collaboration, and the ability to navigate multiple systems while maintaining HIPAA compliance. Ideal candidates have 2+ years as an RN in acute or critical care, an active unrestricted RN license,