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Full Time Cvs Utilization Management Nurse Jobs (NOW HIRING)

Humana

Utilization Management Nurse

The Utilization Management Nurse 2 work assignments are varied and frequently require ... full time (40 hours per week) employment at the time of posting. The pay range may be higher or ...

Humana

Utilization Management Nurse

The Utilization Management Nurse 2 work assignments are varied and frequently require ... full time (40 hours per week) employment at the time of posting. The pay range may be higher or ...

Humana

Utilization Management Nurse

The Utilization Management Nurse 2 work assignments are varied and frequently require ... full time (40 hours per week) employment at the time of posting. The pay range may be higher or ...

Luminis Health

Utilization Management Nurse

Lanham, MD

$34 - $55/hr

Monitors and identifies patterns or trends in utilization management; monitors potential and actual ... full-time employees • Wellness Programs • Employee Assistance Programs and more *Benefit ...

HealthCheck360

Utilization Management Nurse

Dubuque, IA · On-site

Utilization Management Nurse Location : Onsite in Dubuque, IA. Also accepting remote applicants. We ... Full-Time Benefits - Most benefits start day 1 * Medical, Dental, Vision Insurance * Flex Spending ...

Intus, Inc

Contract Utilization Management Nurse

$42/hr

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 ...

HealthCheck360

Utilization Management Nurse

Dubuque, IA · On-site

Utilization Management Nurse Location : Onsite in Dubuque, IA. Also accepting remote applicants. We ... Full-Time Benefits - Most benefits start day 1 * Medical, Dental, Vision Insurance * Flex Spending ...

Luminis Health

Utilization Management Nurse

Annapolis, MD · On-site

$34 - $55/hr

Monitors and identifies patterns or trends in utilization management; monitors potential and actual ... full-time employees • Wellness Programs • Employee Assistance Programs and more *Benefit ...

Solis Health Plans

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 ...

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Full Time Cvs Utilization Management Nurse information

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$39K

$89.5K

$163K

How much do full time cvs utilization management nurse jobs pay per year?

As of Aug 22, 2026, the average yearly pay for full time 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 is the difference between Full Time Cvs Utilization Management Nurse vs Full Time Cvs Case Manager?

AspectFull Time Cvs Utilization Management NurseFull Time Cvs Case Manager
CredentialsRN license, utilization review certificationRN license, case management certification
Work EnvironmentUtilization review teams, insurance companiesPatient homes, healthcare facilities, insurance companies
Employer & IndustryHealthcare insurers, managed care organizationsHospitals, healthcare providers, insurers

Both roles require RN licensure and related certifications, but the Utilization Management Nurse focuses on reviewing medical necessity and optimizing resource use, while the Case Manager coordinates patient care and discharge planning. The roles often overlap but serve distinct functions within healthcare and insurance settings.

What cities are hiring for Full Time Cvs Utilization Management Nurse jobs?

Cities with the most Full Time 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 states have the most Full Time Cvs Utilization Management Nurse jobs?

States with the most job openings for Full Time Cvs Utilization Management Nurse jobs include:

Full Time Cvs Utilization Management Nurse jobs near you

Utilization Management Nurse

Humana

Remote

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 21 days ago

Humana rating

8.0

Company rating: 8.0 out of 10

Based on 266 frontline employees who took The Breakroom Quiz

166th of 311 rated insurance

Job description

Become a part of our caring community
The Utilization Management Nurse 2 utilizes clinical nursing skills to support the coordination, documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action. Reports to the UM Nurse, Manager

The Utilization Management Nurse 2 uses clinical knowledge, communication skills, and independent critical thinking skills towards interpreting criteria, policies, and procedures to provide the best and most appropriate treatment, care or services for members. Coordinates and communicates with providers, members, or other parties to facilitate optimal care and treatment. Understands department, segment, and organizational strategy and operating objectives, including their linkages to related areas. Makes decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal direction and receives guidance where needed. Follows established guidelines/procedures.


Use your skills to make an impact

Required Qualifications

  • Licensed Registered Nurse (RN) with at least 3 years prior clinical experience in an acute care, skilled, long term care or rehabilitation setting

  • Licensed Practical Nurse (LPN) with at least 5 years of clinical experience in acute care, skilled, long term care or rehabilitation setting.

  • MUST reside in the state of FLORIDA

  • License in the state of Florida with no disciplinary action

Preferred Qualifications

  • BSN or Bachelors degree in a related field

  • Prior experience in utilization management/review and or prior authorizations.

  • Background in case management for Long-Term Services and Supports (LTSS) members.

  • Experience with MCG guidelines

  • Experience evaluating requests for durable medical equipment.

  • Familiarity with health plan operations.

Additional Information

- Must work an 8 hour shift between 8:30AM-5:30PM local time Monday-Friday

Work at Home Requirements: To ensure Home or Hybrid Home/Office employees' ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria: At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested. In certain roles, the minimum recommended internet speed required by Humana may not be sufficient for business needs. Humana reserves the right to require associates to upgrade their internet service if necessary. Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.

Scheduled Weekly Hours

40

Pay Range

The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.


$71,100 - $97,800 per year


This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.

Description of Benefits

Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.
About us
About Humana: Humana Inc. (NYSE: HUM) is a leading U.S. healthcare company. Through our Humana insurance services and our CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare and Medicaid, families, individuals, military service personnel, and communities at large. Learn more about what we offer atHumana.comand atCenterWell.com.


Equal Opportunity Employer

It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.

What Humana employees say

Pay

Benefits

Hours and flexibility

Workplace

Get the full story on Breakroom

Humana logo

About Humana

Sourced by ZipRecruiter

Humana Inc., headquartered in Louisville, KY., is a leading health care company that offers a wide range of insurance products and health and wellness services that incorporate an integrated approach to lifelong well-being. By leveraging the strengths of its core businesses, Humana believes it can better explore opportunities for existing and emerging adjacencies in health care that can further enhance wellness opportunities for the millions of people across the nation with whom the company has relationships.

Industry

Health care and social assistance

Company size

10,000+ Employees

Headquarters location

Louisville, KY, US

Year founded

1961

Social media

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