Utilization Management Nurse Des Moines, Iowa, United States Utilization Management Nurse Location: Onsite in Dubuque, IA. Also accepting remote applicants. We are looking for a nurse just like you ...
Utilization Management Nurse Des Moines, Iowa, United States Utilization Management Nurse Location: Onsite in Dubuque, IA. Also accepting remote applicants. We are looking for a nurse just like you ...
Utilization Management Nurse Consultant
$26.01 - $68.55/hr
At CVS Health ® , you'll be surrounded by passionate colleagues who care deeply, innovate with ... Utilization Management is a 24/7 operation and work schedule may include weekends, holidays, and ...
Utilization Management Nurse Consultant
$26.01 - $68.55/hr
At CVS Health ® , you'll be surrounded by passionate colleagues who care deeply, innovate with ... Utilization Management is a 24/7 operation and work schedule may include weekends, holidays, and ...
Utilization Management Nurse Consultant
$26.01 - $68.55/hr
At CVS Health ® , you'll be surrounded by passionate colleagues who care deeply, innovate with ... Utilization Management is a 24/7 operation and work schedule may include weekends, holidays, and ...
Utilization Management Nurse Consultant
$26.01 - $68.55/hr
At CVS Health ® , you'll be surrounded by passionate colleagues who care deeply, innovate with ... Utilization Management is a 24/7 operation and work schedule may include weekends, holidays, and ...
Utilization Management Nurse Consultant
$26.01 - $68.55/hr
At CVS Health ® , you'll be surrounded by passionate colleagues who care deeply, innovate with ... Utilization Management is a 24/7 operation and work schedule may include weekends, holidays, and ...
Utilization Management Nurse Consultant
$26.01 - $68.55/hr
At CVS Health ® , you'll be surrounded by passionate colleagues who care deeply, innovate with ... Utilization Management is a 24/7 operation and work schedule may include weekends, holidays, and ...
Utilization Management Nurse
Dalton, GA · On-site
Job Title Utilization Management Nurse The Utilization Management Nurse performs comprehensive clinical reviews of requested services utilizing clinical criteria, received through various mechanisms.
Utilization Management Nurse
Dalton, GA · On-site
Job Title Utilization Management Nurse The Utilization Management Nurse performs comprehensive clinical reviews of requested services utilizing clinical criteria, received through various mechanisms.
The Utilization Management Nurse performs medical necessity and benefit review requests in accordance with national standards, contractual requirements, and a member's benefit coverage while working ...
Quick apply
The Utilization Management Nurse performs medical necessity and benefit review requests in accordance with national standards, contractual requirements, and a member's benefit coverage while working ...
Reporting to the Director of Utilization Management, the Utilization Management Nurse is responsible for ensuring that patients receive appropriate, cost-effective care by reviewing and evaluating ...
Reporting to the Director of Utilization Management, the Utilization Management Nurse is responsible for ensuring that patients receive appropriate, cost-effective care by reviewing and evaluating ...
Reporting to the Director of Utilization Management, the Utilization Management Nurse is responsible for ensuring that patients receive appropriate, cost-effective care by reviewing and evaluating ...
Reporting to the Director of Utilization Management, the Utilization Management Nurse is responsible for ensuring that patients receive appropriate, cost-effective care by reviewing and evaluating ...
Reporting to the Director of Utilization Management, the Utilization Management Nurse is responsible for ensuring that patients receive appropriate, cost-effective care by reviewing and evaluating ...
Reporting to the Director of Utilization Management, the Utilization Management Nurse is responsible for ensuring that patients receive appropriate, cost-effective care by reviewing and evaluating ...
Utilization Management Nurse
Chapel Hill, NC · On-site +1
The Utilization Management Nurse performs medical necessity and benefit review requests in accordance with national standards, contractual requirements, and a member's benefit coverage while working ...
Utilization Management Nurse
Chapel Hill, NC · On-site +1
The Utilization Management Nurse performs medical necessity and benefit review requests in accordance with national standards, contractual requirements, and a member's benefit coverage while working ...
Contract Utilization Management Nurse IntusCare is the only end-to-end ecosystem built specifically to help Programs of All-Inclusive Care for the Elderly (PACE) programs deliver exceptional care ...
Contract Utilization Management Nurse IntusCare is the only end-to-end ecosystem built specifically to help Programs of All-Inclusive Care for the Elderly (PACE) programs deliver exceptional care ...
The Utilization Management Nurse performs medical necessity and benefit review requests in accordance with national standards, contractual requirements, and a member's benefit coverage while working ...
The Utilization Management Nurse performs medical necessity and benefit review requests in accordance with national standards, contractual requirements, and a member's benefit coverage while working ...
Utilization Management Nurse
Dubuque, IA · On-site
Utilization Management Nurse Cottingham & Butler/ SISCO 1 Positions ID: 4627707008 Posted On 07/01/2025 Refreshed On 07/15/2026 Job Overview Utilization Management Nurse Location : Onsite in Dubuque ...
Utilization Management Nurse
Dubuque, IA · On-site
Utilization Management Nurse Cottingham & Butler/ SISCO 1 Positions ID: 4627707008 Posted On 07/01/2025 Refreshed On 07/15/2026 Job Overview Utilization Management Nurse Location : Onsite in Dubuque ...
Lead Utilization Management Nurse
Oak Brook, IL · On-site +1
We have an innovative organization looking to add a Lead Utilization Management Nurse to its team. Their main purpose is to enable physicians to engage, support, and manage new value-based savings ...
Quick apply
Lead Utilization Management Nurse
Oak Brook, IL · On-site +1
We have an innovative organization looking to add a Lead Utilization Management Nurse to its team. Their main purpose is to enable physicians to engage, support, and manage new value-based savings ...
As a Utilization Management Nurse on the team, you will be responsible for reviewing patient files and treatment methods with an eye for efficiency and effectiveness. Your role will be to ensure we ...
As a Utilization Management Nurse on the team, you will be responsible for reviewing patient files and treatment methods with an eye for efficiency and effectiveness. Your role will be to ensure we ...
Utilization Management Nurse
Los Angeles, CA · On-site
$60 - $75/hr
As a Utilization Management Nurse on the team, you will be responsible for reviewing patient files and treatment methods with an eye for efficiency and effectiveness. Your role will be to ensure we ...
Quick apply
Utilization Management Nurse
Los Angeles, CA · On-site
$60 - $75/hr
As a Utilization Management Nurse on the team, you will be responsible for reviewing patient files and treatment methods with an eye for efficiency and effectiveness. Your role will be to ensure we ...
Role Overview The Contract Utilization Management Nurse plays a critical role in ensuring high-quality, cost-effective, and compliant care for PACE participants supported by IntusCare. This ...
Role Overview The Contract Utilization Management Nurse plays a critical role in ensuring high-quality, cost-effective, and compliant care for PACE participants supported by IntusCare. This ...
Role Overview The Contract Utilization Management Nurse plays a critical role in ensuring high-quality, cost-effective, and compliant care for PACE participants supported by IntusCare. This ...
Role Overview The Contract Utilization Management Nurse plays a critical role in ensuring high-quality, cost-effective, and compliant care for PACE participants supported by IntusCare. This ...
Utilization Management Nurse Reports To: Manager of Utilization Management Employment Type: Full-Time, Exempt Brief Description of Duties: This position is reserved for a licensed Registered Nurse ...
Quick apply
Utilization Management Nurse Reports To: Manager of Utilization Management Employment Type: Full-Time, Exempt Brief Description of Duties: This position is reserved for a licensed Registered Nurse ...
Utilization Management Nurse
Miami, FL · On-site
$60K - $70K/yr
Under the supervision of the Health Services Director, the Utilization Management Nurse (LPN or RN) uses a multidisciplinary approach to organize, coordinate, monitor, evaluate, create and manage ...
Quick apply
Utilization Management Nurse
Miami, FL · On-site
$60K - $70K/yr
Under the supervision of the Health Services Director, the Utilization Management Nurse (LPN or RN) uses a multidisciplinary approach to organize, coordinate, monitor, evaluate, create and manage ...
Cvs Utilization Management Nurse information
See salary details
$39K - $50.3K
15% of jobs
$50.3K - $61.5K
8% of jobs
$63.2K is the 25th percentile. Wages below this are outliers.
$61.5K - $72.8K
15% of jobs
The median wage is $79.9K / yr.
$72.8K - $84.1K
20% of jobs
$84.1K - $95.4K
11% of jobs
$101K is the 75th percentile. Wages above this are outliers.
$95.4K - $106.6K
13% of jobs
$106.6K - $117.9K
5% of jobs
$117.9K - $129.2K
3% of jobs
$129.2K - $140.5K
4% of jobs
$140.5K - $151.7K
3% of jobs
$151.7K - $163K
3% of jobs
$39K
$89.5K
$163K
How much do cvs utilization management nurse jobs pay per year?
As of Aug 11, 2026, the average yearly pay for cvs 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 are the typical responsibilities of a CVS Utilization Management Nurse?
A CVS Utilization Management Nurse typically reviews hospital admissions, outpatient procedures, and ongoing treatments to ensure medical necessity and compliance with coverage guidelines. Daily tasks often include collaborating with healthcare providers, assessing clinical documentation, and communicating decisions to both patients and providers. Nurses in this role may also participate in team meetings, contribute to quality improvement initiatives, and stay current with policy updates. This position offers the opportunity to work closely with a multidisciplinary team while utilizing both clinical expertise and critical thinking skills.
What are the key skills and qualifications needed to thrive as a CVS Utilization Management Nurse?
To thrive as a Cvs Utilization Management Nurse, you need a solid clinical background in nursing, current RN licensure, and experience in medical necessity reviews and case management. Proficiency with utilization management software, electronic health records (EHRs), and knowledge of regulatory guidelines like CMS and NCQA are vital. Strong analytical skills, attention to detail, effective communication, and the ability to multitask make candidates stand out in this role. These skills ensure accurate evaluations, efficient care coordination, and compliance with industry standards, which are critical for improving patient outcomes and optimizing healthcare resources.
What is a CVS Utilization Management Nurse?
A CVS Utilization Management Nurse is responsible for reviewing patient care to ensure treatments are medically necessary and cost-effective. They assess healthcare services against clinical guidelines, work with providers to coordinate patient care, and help manage insurance approvals. Their role involves applying evidence-based criteria to make coverage decisions, preventing unnecessary procedures, and supporting quality care. This position is critical in balancing patient needs with healthcare costs while ensuring compliance with industry regulations.
More about Cvs Utilization Management Nurse jobs
What cities are hiring for Cvs Utilization Management Nurse jobs? Cities with the most Cvs Utilization Management Nurse job openings:
What are the most commonly searched types of Cvs Utilization Management Nurse jobs? The most popular types of Cvs Utilization Management Nurse jobs are:
What job categories do people searching Cvs Utilization Management Nurse jobs look for? The top searched job categories for Cvs Utilization Management Nurse jobs are:
- Internship Rn Utilization Review Nurse
- Utilization Management Review Nurse
- Utilization Review Nurse Compact License
- Online Utilization Review
- Volunteer Rn Utilization Review Nurse
- Utilization Review Case Manager
- Cigna Utilization Review Nurse
- From Home Anthem Utilization Review Nurse
- International Utilization Review Rn
- Rn Utilization Review Nurse
Other
Medical, Dental, Vision, Life, Retirement, PTO
Posted 17 days ago
Cottingham & Butler rating
8.6
Based on 15 frontline employees who took The Breakroom Quiz
89th of 304 rated insurance
Job description
Utilization Management Nurse
Des Moines, Iowa, United States
Utilization Management Nurse
Location: Onsite in Dubuque, IA. Also accepting remote applicants.
We are looking for a nurse just like you - a nurse that thrives in a fast-paced environment, enjoys making a difference for patients, and prefers working in a professional office setting with daytime office hours and weekends/holidays off.
This position is responsible for working telephonically with providers to evaluate and pre-certify requests such as hospital stays, outpatient surgeries, outpatient tests, care, etc. Review requests and match up to an evidence-based guideline to ensure proper care and ensure the right service is happening at the right time and is medically necessary. In this position you will be handling multiple provider phone calls at any given time and need to be able to handle a very fast paced environment. You will also work closely with participants for referrals to case management and condition management services according to referral criteria and health plan guidelines.
Qualified candidates will have strong multitasking skills, RN and clinical experience, preferably in ER, ICU, mental health, orthopedics, and/or pain management. Bilingual is also preferred.
Full-Time Benefits - Most benefits start day 1
- Medical, Dental, Vision Insurance
- Flex Spending or HSA
- 401(k) with company match
- Profit-Sharing/Defined Contribution (1-year waiting period)
- PTO/Paid Holidays
- Company-paid ST and LT Disability
- Maternity Leave/Parental Leave
- Subsidized Parking
- Company-paid Term Life/Accidental Death Insurance
What Cottingham & Butler employees say
Pay
Benefits
Hours and flexibility
Workplace
Get the full story on Breakroom