RN Utilization Management Consultant - Weekend Shifts

CVS Health; Central City (KY); Hybrid; USD 36,000 - 77,000; Full time

Job summary

CVS Health is seeking an RN for Utilization Management on a full-time schedule. The role involves assessing and coordinating care, applying clinical criteria, and communicating with providers to support coverage decisions.

Weekend and evening hours may be required in a 24/7 operation. Requires active RN licensure in Kentucky or multi-state compact, 3+ years of clinical experience, and strong computer skills navigating multiple systems.

Qualifications

• Weekend position availability (Sat/Sun + 2 weekdays)
• Active, current and unrestricted RN licensure in Kentucky or multi-state compact
• 3+ years of clinical experience
• Proficiency with computer systems navigating multiple platforms
• Ability to work in a fast-paced environment

Responsibilities

• Assess and coordinate care to facilitate appropriate services and benefits
• Gather and apply clinical criteria and guidelines to determine coverage decisions
• Communicate with providers and other stakeholders to support treatment plans
• Collaborate with internal and external teams to optimize utilization management
• Meet standard productivity and quality expectations

Skills

Weekend availability

Communication

Computer skills

Education

Associates degree required

BSN preferred

Tools

EHR systems

Job description

CVS Health is seeking an RN for Utilization Management on a full-time schedule. The role involves assessing and coordinating care, applying clinical criteria, and communicating with providers to support coverage decisions.

Weekend and evening hours may be required in a 24/7 operation. Requires active RN licensure in Kentucky or multi-state compact, 3+ years of clinical experience, and strong computer skills navigating multiple systems.