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Apprentice Utilization Management Nurse Jobs (NOW HIRING)

CVS Health

Utilization Management Nurse Consultant

$29.10 - $62.32/hr

Registered Nurse (RN) - Utilization Management (24/7 Operations) Step away from bedside care and make a system-wide impact. Join our Utilization Management team and help ensure members receive the ...

Oak St. Health

Utilization Management Nurse Consultant

$26.01 - $74.78/hr

... N licensure in state of residence Utilization Management is a 24/7 operation and work schedules will include weekends, holidays, and evening hours Preferred Qualifications - 2+ years of clinical ...

Oak St. Health

Utilization Management Nurse Consultant

$32.01 - $68.55/hr

... N licensure in state of residence Utilization Management is a 24/7 operation and work schedules will include weekends, holidays, and evening hours Preferred Qualifications - 2+ years of clinical ...

Oak St. Health

Utilization Management Nurse Consultant

$32.01 - $68.55/hr

... N licensure in state of residence Utilization Management is a 24/7 operation and work schedules will include weekends, holidays, and evening hours Preferred Qualifications - 2+ years of clinical ...

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Apprentice Utilization Management Nurse information

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$39K

$89.5K

$163K

How much do apprentice utilization management nurse jobs pay per year?

As of Jul 12, 2026, the average yearly pay for apprentice utilization management nurse in the United States is $89,483.00, according to ZipRecruiter salary data. Most workers in this role earn between $64,500.00 and $104,500.00 per year, depending on experience, location, and employer.

What is the difference between Apprentice Utilization Management Nurse vs Utilization Management Nurse?

AspectApprentice Utilization Management NurseUtilization Management Nurse
CredentialsLicensed RN, in training or early certification stageLicensed RN with certification in utilization review
Work EnvironmentSupervised training setting, often in healthcare or insurance companiesIndependent review in healthcare or insurance organizations
Job ResponsibilitiesAssisting with case reviews, learning utilization review processesConducting case assessments, making coverage decisions

The Apprentice Utilization Management Nurse is in training, focusing on learning review procedures under supervision, while the Utilization Management Nurse is fully qualified, responsible for independent case evaluations and decision-making. The apprentice role is a stepping stone toward becoming a licensed Utilization Management Nurse.

What are the key skills and qualifications needed to thrive as an Apprentice Utilization Management Nurse, and why are they important?

To thrive as an Apprentice Utilization Management Nurse, you need a foundational understanding of nursing principles, strong analytical skills, and typically an RN license or progression toward one. Familiarity with utilization management software, electronic health records (EHR), and knowledge of insurance guidelines such as Medicare or Medicaid are often required. Attention to detail, critical thinking, and effective communication are essential soft skills for collaborating with healthcare teams and conveying clinical information. These competencies ensure accurate patient care reviews, compliance with regulations, and effective support in healthcare cost management.

What are some common challenges faced by Apprentice Utilization Management Nurses, and how can they be addressed?

Apprentice Utilization Management Nurses often encounter challenges such as learning to interpret complex medical records, understanding insurance policies, and adhering to strict regulatory guidelines. Balancing patient advocacy with cost-effective care decisions can also be demanding. These challenges can be addressed by actively participating in mentorship programs, seeking regular feedback from experienced colleagues, and utilizing ongoing training resources provided by employers. Developing strong communication and organizational skills will also help manage the workload and foster effective collaboration with physicians, case managers, and insurance representatives.

What is an Apprentice Utilization Management Nurse?

An Apprentice Utilization Management Nurse is a nursing professional in training who assists with the review and evaluation of healthcare services to ensure they are medically necessary and cost-effective. They work under the supervision of experienced utilization management nurses and follow established guidelines to assess patient care plans, medical records, and insurance policies. Their role is crucial in helping healthcare organizations maintain quality care while managing costs, and they may interact with physicians, patients, and insurance companies to clarify or justify treatment decisions. As apprentices, they are gaining hands-on experience to develop their skills and knowledge in utilization management.
What cities are hiring for Apprentice Utilization Management Nurse jobs? Cities with the most Apprentice Utilization Management Nurse job openings:
What are the most commonly searched types of Utilization Management Nurse jobs? The most popular types of Utilization Management Nurse jobs are:
What states have the most Apprentice Utilization Management Nurse jobs? States with the most job openings for Apprentice Utilization Management Nurse jobs include:
Apprentice Utilization Management Nurse jobs near you
Utilization Management Nurse Consultant

Utilization Management Nurse Consultant

CVS Health

Remote

$29.10 - $62.32/hr

Other

Medical, Dental, Vision, Retirement, PTO

Posted 13 days ago

CVS Health rating

5.8

Company rating: 5.8 out of 10

Based on 4,277 frontline employees who took The Breakroom Quiz

82nd of 104 rated pharmacies

Job description

Registered Nurse (RN) – Utilization Management (24/7 Operations)

Step away from bedside care and make a system-wide impact. Join our Utilization Management team and help ensure members receive the right care at the right time.

What You'll Do

  • Review clinical information and apply guidelines to support coverage decisions
  • Collaborate with providers and care teams to coordinate appropriate treatment
  • Identify opportunities to improve care quality and resource utilization
  • Connect members to programs and services that support better outcomes
  • Provide clinical expertise across internal and external teams

What You Bring - REQUIRED

  • Active, unrestricted RN license in your state of residence
  • 2+ years of adult acute care or critical care experience
  • Strong clinical judgment, communication, and organizational skills
  • Ability to multitask and thrive in a fast-paced, technology-driven environment

Preferred

  • Experience in Med-Surg or a specialty area
  • Managed Care or Utilization Management experience
  • Located in Central, Mountain, or Pacific time zones

Schedule & Work Environment

  • 24/7 operations, including evenings, weekends, and holidays
  • Sedentary, computer-based role with high attention to detail and productivity expectations

Education

  • Associate's Degree required

BSN preferred

Anticipated Weekly Hours

40

Time Type

Full time

Pay Range

The typical pay range for this role is:

$29.10 - $62.32

This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above.

Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.

Great benefits for great people

We take pride in offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families.

This full‑time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial well‑being of colleagues and their families. The benefits for this position include medical, dental, and vision coverage, paid time off, retirement savings options, wellness programs, and other resources, based on eligibility.

Additional details about available benefits are provided during the application process and on Benefits Moments.

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