Utilization Management Nurse Consultant - Weekends (4-10 hour shifts)

CVS Health; Texas; Remote; USD 36,000 - 85,000; Full time

Benefits offered by this job

Medical coverage

Dental coverage

Vision coverage

PTO

Job summary

CVS Health is hiring an Utilization Management Nurse Consultant to enhance patient outcomes through clinical assessment in a remote environment. The role emphasizes collaboration with care teams, applying guidelines, and coordinating treatment plans to ensure appropriate care and utilization management.

The RN with 3+ years of experience, including Med/Surg, and an Associate’s degree (BSN preferred) will support coverage decisions and connect members to additional services as needed.

Qualifications

• Associate’s degree required, BSN preferred.
• 3+ years of RN experience.
• 1+ year Med/Surg experience.

Responsibilities

• Review and assess clinical information to support coverage determinations.
• Apply clinical guidelines, policies, and sound judgment across the care continuum.
• Collaborate with providers and care teams to coordinate treatment plans.
• Identify opportunities to enhance quality, efficiency, and member outcomes.
• Refer members to additional programs and services as appropriate.
• Serve as a clinical resource within utilization/benefit management.

Skills

RN experience

Med/Surg experience

Education

Associate’s degree

BSN

Job description

About This Role

The Utilization Management Nurse Consultant at CVS Health is a detail-oriented RN role focused on improving healthcare outcomes by ensuring members receive appropriate care. This position is ideal for those passionate about clinical assessment and collaboration within a remote work environment.

Highlights

• Pay: $26.01 - $62.32/hour
• Location: Remote, TX
• Schedule: Full-time, Weekend shifts (Friday–Monday, 10-hour shifts)

What You'll Do

• Review and assess clinical information to support coverage determinations
• Apply clinical guidelines, policies, and sound judgment across the care continuum
• Collaborate with providers and care teams to coordinate treatment plans
• Identify opportunities to enhance quality, efficiency, and member outcomes
• Refer members to additional programs and services as appropriate
• Serve as a clinical resource within utilization/benefit management

Requirements

Education

• Associate’s degree required, BSN preferred

Experience

• 3+ years of RN experience
• 1+ year Med/Surg experience

Licenses & Certifications

• Active, unrestricted RN license in state of residence required

Benefits

• Medical, dental, and vision coverage
• Paid time off
• Retirement savings options
• Wellness programs and other resources

About CVS Health

CVS Health is a leading healthcare provider committed to delivering exceptional patient care. They prioritize safety and quality while fostering a collaborative work environment that values every colleague.