Provide system-level leadership and operational oversight of the Behavioral Health Utilization Review (UR) and Utilization Management (UM) processes across two hospital campuses and multiple ...
Provide system-level leadership and operational oversight of the Behavioral Health Utilization Review (UR) and Utilization Management (UM) processes across two hospital campuses and multiple ...
Utilization Management Nurse Consultant
$29.10 - $62.32/hr
Medical
Dental
Vision
Retirement
PTO
Registered Nurse (RN) - Utilization Management Remote | Afternoon/Evening Shifts Available | 24/7 ... This position is eligible for a CVS Health bonus, commission or short-term incentive program in ...
Utilization Management Nurse Consultant
$29.10 - $62.32/hr
Medical
Dental
Vision
Retirement
PTO
Registered Nurse (RN) - Utilization Management Remote | Afternoon/Evening Shifts Available | 24/7 ... This position is eligible for a CVS Health bonus, commission or short-term incentive program in ...
Utilization Management Nurse Consultant
$29.10 - $62.32/hr
Medical
Dental
Vision
Retirement
PTO
Utilization Management Nurse Consultant (RN) Join a team that makes a difference in healthcare ... This position is eligible for a CVS Health bonus, commission or short-term incentive program in ...
Utilization Management Nurse Consultant
$29.10 - $62.32/hr
Medical
Dental
Vision
Retirement
PTO
Utilization Management Nurse Consultant (RN) Join a team that makes a difference in healthcare ... This position is eligible for a CVS Health bonus, commission or short-term incentive program in ...
Utilization Management Nurse Consultant
$29.10 - $62.32/hr
Medical
Dental
Vision
Retirement
PTO
Registered Nurse (RN) - Utilization Management Join a team that makes a difference in healthcare ... This position is eligible for a CVS Health bonus, commission or short-term incentive program in ...
Utilization Management Nurse Consultant
$29.10 - $62.32/hr
Medical
Dental
Vision
Retirement
PTO
Registered Nurse (RN) - Utilization Management Join a team that makes a difference in healthcare ... This position is eligible for a CVS Health bonus, commission or short-term incentive program in ...
Utilization Management Nurse Consultant
$29.10 - $62.32/hr
Medical
Dental
Vision
Retirement
PTO
Registered Nurse (RN) - Utilization Management Make a difference in healthcare from a clinical ... This position is eligible for a CVS Health bonus, commission or short-term incentive program in ...
Utilization Management Nurse Consultant
$29.10 - $62.32/hr
Medical
Dental
Vision
Retirement
PTO
Registered Nurse (RN) - Utilization Management Make a difference in healthcare from a clinical ... This position is eligible for a CVS Health bonus, commission or short-term incentive program in ...
Utilization Management Nurse Consultant
New York, NY · On-site +1
$29.10 - $62.32/hr
Medical
Dental
Vision
Retirement
PTO
Utilization Management is a 24/7 operation and work schedule may include weekends, holidays, and ... This position is eligible for a CVS Health bonus, commission or short-term incentive program in ...
Utilization Management Nurse Consultant
New York, NY · On-site +1
$29.10 - $62.32/hr
Medical
Dental
Vision
Retirement
PTO
Utilization Management is a 24/7 operation and work schedule may include weekends, holidays, and ... This position is eligible for a CVS Health bonus, commission or short-term incentive program in ...
ResponsibilitiesProvide system-level leadership and operational oversight of the Behavioral Health Utilization Review (UR) and Utilization Management (UM) processes across two hospital campuses and ...
ResponsibilitiesProvide system-level leadership and operational oversight of the Behavioral Health Utilization Review (UR) and Utilization Management (UM) processes across two hospital campuses and ...
Utilization Management Nurse Consultant
Harrisburg, PA · On-site
$29.10 - $62.32/hr
Medical
Dental
Vision
Retirement
PTO
Registered Nurse (RN) - Utilization Management Remote | Afternoon/Evening Shifts Available | 24/7 ... This position is eligible for a CVS Health bonus, commission or short-term incentive program in ...
Utilization Management Nurse Consultant
Harrisburg, PA · On-site
$29.10 - $62.32/hr
Medical
Dental
Vision
Retirement
PTO
Registered Nurse (RN) - Utilization Management Remote | Afternoon/Evening Shifts Available | 24/7 ... This position is eligible for a CVS Health bonus, commission or short-term incentive program in ...
Utilization Management Nurse Consultant - Medicare - EST/CST
Home, PA · On-site
$26.01 - $68.55/hr
Medical
Dental
Vision
Retirement
PTO
Position Summary Utilization Management is a 24/7 operation and work schedules will include ... This position is eligible for a CVS Health bonus, commission or short-term incentive program in ...
New
Utilization Management Nurse Consultant - Medicare - EST/CST
Home, PA · On-site
$26.01 - $68.55/hr
Medical
Dental
Vision
Retirement
PTO
Position Summary Utilization Management is a 24/7 operation and work schedules will include ... This position is eligible for a CVS Health bonus, commission or short-term incentive program in ...
New
Utilization Management Nurse Consultant - Medicare - EST/CST
Sanford, ME · On-site
$26.01 - $68.55/hr
Medical
Dental
Vision
Retirement
PTO
Position Summary Utilization Management is a 24/7 operation and work schedules will include ... This position is eligible for a CVS Health bonus, commission or short-term incentive program in ...
New
Utilization Management Nurse Consultant - Medicare - EST/CST
Sanford, ME · On-site
$26.01 - $68.55/hr
Medical
Dental
Vision
Retirement
PTO
Position Summary Utilization Management is a 24/7 operation and work schedules will include ... This position is eligible for a CVS Health bonus, commission or short-term incentive program in ...
New
MI · On-site
$26.01 - $68.55/hr
Medical
Dental
Vision
Retirement
PTO
Position Summary Utilization Management is a 24/7 operation and work schedules will include ... This position is eligible for a CVS Health bonus, commission or short-term incentive program in ...
New
MI · On-site
$26.01 - $68.55/hr
Medical
Dental
Vision
Retirement
PTO
Position Summary Utilization Management is a 24/7 operation and work schedules will include ... This position is eligible for a CVS Health bonus, commission or short-term incentive program in ...
New
Your Role The Behavioral Health Utilization Management (UM) team performs prior authorization and concurrent reviews for members by applying evidenced based guidelines, policies, and nationally ...
Your Role The Behavioral Health Utilization Management (UM) team performs prior authorization and concurrent reviews for members by applying evidenced based guidelines, policies, and nationally ...
Utilization Management Nurse Consultant-1
New York, NY · On-site
$26.01 - $74.78/hr
Medical
Dental
Vision
Retirement
PTO
Position Summary Utilization Management is a 24/7 operation and work schedules will include ... This position is eligible for a CVS Health bonus, commission or short-term incentive program in ...
Utilization Management Nurse Consultant-1
New York, NY · On-site
$26.01 - $74.78/hr
Medical
Dental
Vision
Retirement
PTO
Position Summary Utilization Management is a 24/7 operation and work schedules will include ... This position is eligible for a CVS Health bonus, commission or short-term incentive program in ...
Utilization Management Nurse Consultant - Weekends (4-10 hour shifts)
$26.01 - $62.32/hr
Medical
Dental
Vision
Retirement
PTO
Utilization Management is a 24/7 operation and work schedules will include holidays and evening ... This position is eligible for a CVS Health bonus, commission or short-term incentive program in ...
Utilization Management Nurse Consultant - Weekends (4-10 hour shifts)
$26.01 - $62.32/hr
Medical
Dental
Vision
Retirement
PTO
Utilization Management is a 24/7 operation and work schedules will include holidays and evening ... This position is eligible for a CVS Health bonus, commission or short-term incentive program in ...
MI · On-site
$26.01 - $74.78/hr
Medical
Dental
Vision
Retirement
PTO
Position Summary Utilization Management is a 24/7 operation and work schedules will include ... This position is eligible for a CVS Health bonus, commission or short-term incentive program in ...
New
MI · On-site
$26.01 - $74.78/hr
Medical
Dental
Vision
Retirement
PTO
Position Summary Utilization Management is a 24/7 operation and work schedules will include ... This position is eligible for a CVS Health bonus, commission or short-term incentive program in ...
New
Utilization Management Nurse Consultant-1
Sanford, ME · On-site
$26.01 - $74.78/hr
Medical
Dental
Vision
Retirement
PTO
Position Summary Utilization Management is a 24/7 operation and work schedules will include ... This position is eligible for a CVS Health bonus, commission or short-term incentive program in ...
New
Utilization Management Nurse Consultant-1
Sanford, ME · On-site
$26.01 - $74.78/hr
Medical
Dental
Vision
Retirement
PTO
Position Summary Utilization Management is a 24/7 operation and work schedules will include ... This position is eligible for a CVS Health bonus, commission or short-term incentive program in ...
New
Behavioral Health Utilization Management Specialist
Hastings, MI · On-site
$58K/yr
We are seeking a detail-oriented and clinically skilled Behavioral Health Utilization Management (UM) Specialist to join our team. This role is responsible for reviewing behavioral health services to ...
Quick apply
Behavioral Health Utilization Management Specialist
Hastings, MI · On-site
$58K/yr
We are seeking a detail-oriented and clinically skilled Behavioral Health Utilization Management (UM) Specialist to join our team. This role is responsible for reviewing behavioral health services to ...
Utilization Management Nurse Consultant
$32.01 - $68.55/hr
Medical
Dental
Vision
Retirement
PTO
Position Summary Utilization Management is a 24/7 operation and work schedules will include ... This position is eligible for a CVS Health bonus, commission or short-term incentive program in ...
Utilization Management Nurse Consultant
$32.01 - $68.55/hr
Medical
Dental
Vision
Retirement
PTO
Position Summary Utilization Management is a 24/7 operation and work schedules will include ... This position is eligible for a CVS Health bonus, commission or short-term incentive program in ...
Utilization Management Nurse Consultant
$29.10 - $62.32/hr
Medical
Dental
Vision
Retirement
PTO
Position Summary Utilization Management is a 24/7 operation and work schedules will include ... This position is eligible for a CVS Health bonus, commission or short-term incentive program in ...
Utilization Management Nurse Consultant
$29.10 - $62.32/hr
Medical
Dental
Vision
Retirement
PTO
Position Summary Utilization Management is a 24/7 operation and work schedules will include ... This position is eligible for a CVS Health bonus, commission or short-term incentive program in ...
Utilization Management Nurse Consultant - Medicare - EST/CST
New York, NY · On-site
$26.01 - $68.55/hr
Medical
Dental
Vision
Retirement
PTO
Position Summary Utilization Management is a 24/7 operation and work schedules will include ... This position is eligible for a CVS Health bonus, commission or short-term incentive program in ...
Utilization Management Nurse Consultant - Medicare - EST/CST
New York, NY · On-site
$26.01 - $68.55/hr
Medical
Dental
Vision
Retirement
PTO
Position Summary Utilization Management is a 24/7 operation and work schedules will include ... This position is eligible for a CVS Health bonus, commission or short-term incentive program in ...
Commission Cvs Health Utilization Management information
See salary details
$21.39 - $25.72
2% of jobs
$25.72 - $30.05
9% of jobs
$33.01 is the 25th percentile. Wages below this are outliers.
$30.05 - $34.38
21% of jobs
The median wage is $37.88 / hr.
$34.38 - $38.70
23% of jobs
$38.70 - $43.03
13% of jobs
$46.39 is the 75th percentile. Wages above this are outliers.
$43.03 - $47.36
10% of jobs
$47.36 - $51.68
8% of jobs
$51.68 - $56.01
5% of jobs
$56.01 - $60.34
5% of jobs
$60.34 - $64.66
2% of jobs
$64.66 - $68.99
2% of jobs
$21
$42
$68
How much do commission cvs health utilization management jobs pay per hour?
As of Aug 16, 2026, the average hourly pay for commission cvs health utilization management in the United States is $42.28, according to ZipRecruiter salary data. Most workers in this role earn between $33.41 and $48.56 per hour, depending on experience, location, and employer.
What is a Commission CVS Health Utilization Management?
A Commission CVS Health Utilization Management role involves evaluating and coordinating healthcare services to ensure patients receive appropriate, cost-effective care. These professionals assess medical necessity, review authorization requests, and work closely with providers, patients, and insurance plans. Their goal is to optimize healthcare resources while maintaining quality care standards, often by applying clinical guidelines and industry regulations. The role typically requires a background in healthcare, nursing, or pharmacy and strong analytical and communication skills.
What are the key skills and qualifications needed to thrive as a Commission CVS Health Utilization Management professional?
To thrive as a CVS Health Utilization Management professional, you need a background in healthcare, strong analytical skills, and typically a valid RN license or relevant clinical degree. Familiarity with utilization review systems, electronic health records (EHR), and regulatory guidelines such as Medicare and Medicaid is essential. Strong communication, attention to detail, and critical thinking are standout soft skills for this role. These skills are vital to ensure appropriate, cost-effective patient care and compliance with healthcare policies.
What are the typical challenges faced by a Commission CVS Health Utilization Management professional when reviewing complex cases?
Commission CVS Health Utilization Management professionals often encounter challenges such as interpreting nuanced medical information, staying updated with evolving clinical guidelines, and balancing cost-effectiveness with patient care needs. Complex cases may require collaboration with physicians, nurses, and pharmacists, as well as thorough documentation to ensure compliance with regulations. Managing a high volume of cases while maintaining accuracy and timeliness is also a common aspect of the role.
What is the difference between Commission Cvs Health Utilization Management vs Utilization Review Nurse?
| Aspect | Commission Cvs Health Utilization Management | Utilization Review Nurse |
|---|---|---|
| Certifications | CPUR, CCM, or relevant healthcare certifications | RN license, possibly with certifications like CURN |
| Work Environment | Insurance companies, healthcare providers, or managed care organizations | Hospitals, clinics, or insurance companies |
| Primary Responsibilities | Reviewing medical necessity, authorizing services, managing utilization data | Assessing patient records, determining care appropriateness, authorizing treatments |
Both roles focus on evaluating healthcare services, but Commission Cvs Health Utilization Management often involves broader program oversight and data analysis, while Utilization Review Nurses primarily conduct clinical assessments. Understanding these differences helps job seekers identify the right career path in healthcare utilization roles.
More about Commission Cvs Health Utilization Management jobs
What cities are hiring for Commission Cvs Health Utilization Management jobs?
Cities with the most Commission Cvs Health Utilization Management job openings:
What are the most commonly searched types of Cvs Health Utilization Management jobs?
The most popular types of Cvs Health Utilization Management jobs are:
What states have the most Commission Cvs Health Utilization Management jobs?
States with the most job openings for Commission Cvs Health Utilization Management jobs include:
What job categories do people searching Commission Cvs Health Utilization Management jobs look for?
The top searched job categories for Commission Cvs Health Utilization Management jobs are:
Full-time
Posted 16 days ago
Piedmont Healthcare rating
7.1
Based on 466 frontline employees who took The Breakroom Quiz
381st of 887 rated healthcare providers
Job description
Provide system-level leadership and operational oversight of the Behavioral Health Utilization Review (UR) and Utilization Management (UM) processes across two hospital campuses and multiple Behavioral Health programs, including inpatient, ED-based, and specialty BH services. Responsible for ensuring consistent, compliant, and effective UR operations that support appropriate level-of-care determination, medical necessity, denial prevention, and financial performance. Serves as a primary point of contact and collaborative partner with multiple system teams, including but not limited to Revenue Cycle, Case Management, Compliance, Finance, HIM, Epic, Physician Advisors, and Executive Leadership, to align utilization practices with regulatory, payer, and organizational expectations.
Education
Piedmont Healthcare Corporate
Education
- Bachelors Degree in Nursing, Business Administration, Health Administration, Social Work, or a closely related field Required
- 5 years of experience in Behavioral Health Utilization Management and Utilization Review processes using medical necessity criteria (InterQual and/or Milliman).
- 2 years Experience requirement above, to include, 2 years of demonstrated leadership or management experience in a hospital, medical practice, or other healthcare setting Required
- Experience working in a system-level or multi-site environment Preferred
- RN - Registered Nurse - Georgia State Licensure and/or NLC/eNCL Multistate Licensure Required or
- LPC-Licensed Professional Counselor Required or
- LMSW - Licensed Medical Social Worker - State Licensure Required or
- LCSW- License Clinical Social Worker Required or
- Licensed Marriage and Family Therapist (LMFT) Required
- IQCI Certification Required
Piedmont Healthcare Corporate
What Piedmont Healthcare employees say
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Benefits
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About Piedmont
Sourced by ZipRecruiter
Industry
Health care and social assistance
Company size
10,000+ Employees
Headquarters location
Atlanta, GA, US
Year founded
1905