CVS Health
Utilization Management Nurse Consultant (Weekend)
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Utilization Management Nurse Consultant (Weekend)
Clinical Nurse Utilization Manager (Work-From-Home Role)
We’re building a world of health around every individual — shaping a more connected, convenient, and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold themselves accountable, and prioritize safety and quality in everything we do. Join us and be part of something bigger — helping to simplify healthcare one person, one family, and one community at a time.
Schedule & Work Arrangements
This is an Alternative Work Schedule weekend position, requiring coverage of both Saturday and Sunday each week.
- Scheduling options may include:
- Four 10-hour shifts
- Five 8-hour shifts
- Three 12-hour shifts
- Other approved configurations
Specific schedules will be determined in collaboration with management to ensure adequate weekend coverage.
Position Summary
Utilize your clinical experience and skills in a collaborative process to assess, plan, implement, coordinate, monitor, and evaluate options to facilitate appropriate healthcare services and benefits for members.
Key Responsibilities
- Gather clinical information and apply appropriate clinical criteria, guidelines, policies, procedures, and clinical judgment to render coverage determinations and recommendations along the continuum of care.
- Communicate with providers and other parties to facilitate care and treatment. Identify members for referral opportunities to integrate with other products, services, or benefit programs.
- Identify opportunities to promote quality and effectiveness of healthcare services and benefit utilization.
- Consult and lend expertise to other internal and external stakeholders in the coordination and administration of utilization/benefit management.
- Meet set productivity and quality expectations as established by UTMC.
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Work Location & Availability
This role is a work-from-home position. During work hours:
- Colleagues must be available by phone, videoconference, and email as required.
- Occasional on-site attendance may be required for meetings, training sessions, or other events as directed.
Required Qualifications
Education & Experience
- Diploma RN is acceptable.
- Associate degree or BSN preferred.
- 3+ years of experience as a Registered Nurse.
- 1+ years of clinical experience in acute or post-acute setting.
- 1+ years of Utilization Management / Care Management Experience.
- Active, current, and unrestricted RN licensure in state of residence.
- May be required to obtain additional Nursing Licenses as business needs require.
Preferred Qualifications (Not mandatory but advantageous)
- Utilization review experience.
- Experience with LTAC (Long-Term Acute Care), skilled rehab, or home health.
- Managed Care experience.
- BSN degree.
Hours & Compensation
- Anticipated Weekly Hours: 40
- Time Type: Full-time
- Pay Range: $29.10 – $62.32 per hour
- This range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls.
- Actual base salary will depend on experience, education, geography, and other relevant factors.
- Position eligible for bonus, commission, or short-term incentive program in addition to base pay.
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Culture & Benefits
"Our people fuel our future"
We are dedicated to fostering a workplace where every colleague feels valued and that they belong. Our teams reflect the diversity of the customers, patients, members, and communities we serve.
Great Benefits for Great People
As a full-time colleague, you’ll enjoy:
- Medical, dental, and vision coverage.
- Paid Time Off (PTO).
- Retirement savings options.
- Wellness programs and other resources.
- Competitive benefits tailored to support both physical, emotional, and financial well-being.
Detailed benefits information is provided during the application process or on Benefits Moments.
Inclusivity Statement
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws.
Why Choose CVS Health®?
At CVS Health, our Work Experience blends culture, values, sustainability, and recognition programs — but above all, it’s about our people.
Our colleagues are: ✅ Self-disciplined and hardworking. ✅ Curious and trustworthy. ✅ Humble and truthful in their decision-making. ✅ Committed to collaboration and making a difference.
We’re proud to be recognized as the #1 Top Workplace in our region!
(Application deadline: 07/07/2026)
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