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Full Time Cvs Utilization Management Nurse Jobs (NOW HIRING)

Humana

Utilization Management Nurse

As a Utilization Management (UM) Nurse, you will play a vital role in improving the health and well ... full time (40 hours per week) employment at the time of posting. The pay range may be higher or ...

Humana

Utilization Management Nurse

As a Utilization Management (UM) Nurse, you will play a vital role in improving the health and well ... full time (40 hours per week) employment at the time of posting. The pay range may be higher or ...

MUSC

Utilization Management Nurse-1

Murrells Inlet, SC · On-site

... Nurse required. Prior leadership experience preferred. One year of case management and/or utilization management work experience preferred. Staff hired prior to July 1, 2013 will be grandfathered in ...

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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 Consultant - Weekends (4-10 hour shifts)

CVS Health

Remote

$26.01 - $62.32/hr

Full-time

Medical, Dental, Vision, Retirement, PTO

Posted 12 days ago

CVS Health rating

5.8

Company rating: 5.8 out of 10

Based on 4,341 frontline employees who took The Breakroom Quiz

91st of 113 rated pharmacies

Job description

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 ourselvesaccountable and prioritize safety and quality in everything we do. Join us and be part of something bigger - helping to simplify health care one person, one family and one community at a time.

Position Summary

Medicare Precertification Utilization Management Nurse Consultant position:

Utilization Management is a 24/7 operation and work schedules will include holidays and evening hours

  • Utilizes clinical experience and skills in a collaborative process to assess, plan, implement, coordinate, monitor and evaluate options to facilitate appropriate healthcare services/benefits for members.

  • Gathers clinical information and applies the appropriate clinical criteria/guideline, policy, procedure and clinical judgment to render coverage determination/recommendation along the continuum of care.

  • Communicates with providers and other parties to facilitate care/treatment

  • Identifies members for referral opportunities to integrate with other products, services and/or programs

  • Identifies opportunities to promote quality effectiveness of Healthcare Services and benefit utilization

  • Consults and lends expertise to other internal and external constituents in the coordination and administration of the utilization/benefit management function.

Required Qualifications

  • 3+ years of experience as a Registered Nurse

  • Must have active current and unrestricted RN licensure in state of residence

  • 1+ years of Med/Surg experience

  • 1+ years of experience with Microsoft Office applications (Outlook, Teams, Excel)

  • Must be willing and able to work Friday, Saturday, Sunday and Monday 10 hr shifts after approx 4-5 months of training Monday - Friday 8:30-5pm EST with occasional holiday rotation.

Preferred Qualifications

  • Prior Authorization or Utilization Management experience

  • Managed care experience

  • Experience using MedCompass

  • Ambulatory surgery experience

Education

Associates degree required

BSN preferred

Work from Home Requirements:

  • You must have or be able to obtain a direct/hardwired internet connection to a modem/router within 7 feet of your computer and a minimum download speed of 25 mbs download and 3 mbs upload. WiFi and satellite internet are not permitted.
  • A quiet, secure and private designated home virtual work location, free from distractions, tidy and organized, compliant with CVS Health and HIPAA guidelines, and allowing for uninterrupted work during work hours.
  • Work-from-Home colleagues are required to work within the state and city where they have confirmed they currently live.
  • The company will provide equipment (keyboard, monitor, computer, headset, etc.). All new hires should provide their own workspace furniture (desk or standing desk, as this position would require you to be at your desk for extended periods of time).
  • If hired, you will commit to obtaining required internet speeds and adhere to all Work From Home requirements.

Technical and Logistical Requirements:

  • Device & System Navigation: Comfortable setting up and using multiple monitors and navigating multiple applications simultaneously to streamline tasks and improve efficiency.
  • Communication Tools: Ability to communicate on digital channels such as via email, calendar invites, Teams messaging, and virtual meetings.
  • Collaboration & Scheduling: Experience with Microsoft Office 365 (Teams, Outlook, Word, Excel, PowerPoint) applications or similar (Google Workspace).
  • Systems Access & Security: Ability to Log in to secure systems (e.g., VPN, EHR portal), lock a computer screen when unattended, manage strong passwords, and recognize suspicious emails or links.
  • Troubleshooting & Support: Ability to resolve common technical issues independently, such as: restarting an application when frozen, resolving internet connection issues, and contacting IT for unresolved technical issues.
  • Future Growth: Openness to learning new skills in the future as the workplace environment evolves

Anticipated Weekly Hours

40

Time Type

Full time

Pay Range

The typical pay range for this role is:

$26.01 - $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 fulltime position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial wellbeing 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.

We anticipate the application window for this opening will close on: 08/22/2026

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.

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