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Full Time Utilization Management Jobs (NOW HIRING)

CVS Health

Utilization Management Nurse Consultant

$26.01 - $62.32/hr

Utilization Management Nurse Consultant Clinical Precertification RN (Medicare) Remote | Full-Time | Weekday Schedule Are you a Registered Nurse ready to make an impact beyond the bedside? Join our ...

CVS Health

Utilization Management Nurse Consultant

$32.01 - $68.55/hr

Position Summary Utilization Management is a 24/7 operation and work schedules will include ... This fulltime position is eligible for a comprehensive benefits package designed to support the ...

CVS Health

Utilization Management Nurse Consultant

$29.10 - $62.32/hr

Position Summary Utilization Management is a 24/7 operation and work schedules will include ... This fulltime position is eligible for a comprehensive benefits package designed to support the ...

Humana

Utilization Management Registered Nurse

As a Utilization Management Registered Nurse: * You will use clinical nursing skills to interpret ... full time (40 hours per week) employment at the time of posting. The pay range may be higher or ...

Devoted Health

Utilization Management Coordinator

$21.70 - $27/hr

The Utilization Management Coordinator plays a vital role in supporting Clinical Operations by ... This is a full-time, remote position working five 8-hour days per week. Shifts are scheduled ...

University of Kentucky

Utilization Management Reviewer Requisition Number: R-000002878 Department Name: Supervisor ... Regular Position Time Status: Full time Equivalency Link Shift: Day (United States of America) Job ...

CVS Health

Utilization Management Nurse Consultant

$29.10 - $62.32/hr

Position Summary Utilization Management is a 24/7 operation and work schedules will include ... This fulltime position is eligible for a comprehensive benefits package designed to support the ...

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Full Time Utilization Management information

See salary details

$39K

$89.5K

$163K

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

As of Sep 14, 2026, the average yearly pay for full time utilization management 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 utilization management?

Utilization Management (UM) in a full-time role involves evaluating the necessity, appropriateness, and efficiency of the use of healthcare services, procedures, and facilities. Professionals in this field, often nurses or healthcare administrators, review patient cases, coordinate with healthcare providers, and ensure that care meets established guidelines while controlling costs. Their goal is to optimize patient outcomes by ensuring the right level of care is provided at the right time, while also helping organizations comply with regulations and insurance requirements.

How does a full time utilization management role typically interact with clinical and administrative teams?

In a Full Time Utilization Management position, you will regularly collaborate with both clinical staff, such as physicians and nurses, and administrative teams, like case managers and billing specialists. Your main responsibility is to review patient care requests, ensure services are medically necessary, and coordinate approvals or denials based on established guidelines. Effective communication and teamwork are essential, as you’ll often facilitate discussions between departments to optimize patient outcomes and resource use. This collaborative environment helps you build a broad understanding of healthcare processes and strengthens your problem-solving skills.

What are the key skills and qualifications needed to thrive as a full time utilization management professional?

To thrive in Full Time Utilization Management, you need a background in healthcare (often as an RN or other clinical license), strong knowledge of medical necessity criteria, and familiarity with insurance guidelines. Expertise in case management software, electronic health records (EHRs), and certifications such as Certified Case Manager (CCM) or Accredited Case Manager (ACM) are typically required. Attention to detail, critical thinking, effective communication, and negotiation skills help you advocate for appropriate patient care while managing costs. These skills ensure efficient resource allocation, compliance with regulations, and optimal patient outcomes within healthcare organizations.

What is the difference between Full Time Utilization Management vs Utilization Review Nurse?

AspectFull Time Utilization ManagementUtilization Review Nurse
CredentialsRN license, certifications in case management or utilization reviewRN license, certifications in utilization review or case management
Work EnvironmentTypically full-time, office-based, healthcare organizationsOften part-time or per review, hospital or insurance settings
Employer & IndustryHealth insurance companies, healthcare providersHospitals, insurance companies, third-party review organizations

Full Time Utilization Management professionals oversee the entire utilization review process, often in a full-time capacity, focusing on managing patient care and resource utilization. Utilization Review Nurses perform specific review tasks, usually on a case-by-case basis, and may work part-time or per review. Both roles require RN licensure and related certifications, but Full Time Utilization Management roles involve broader responsibilities and continuous oversight.

What cities are hiring for Full Time Utilization Management jobs?

Cities with the most Full Time Utilization Management job openings:

What are the most commonly searched types of Utilization Management jobs?

The most popular types of Utilization Management jobs are:

What states have the most Full Time Utilization Management jobs?

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

What are popular job titles related to Full Time Utilization Management jobs?

For Full Time Utilization Management jobs, the most frequently searched job titles are:

Full Time Utilization Management jobs near you

Utilization Management Nurse Consultant

Remote

CVS Health
Health Care and Social Assistance • 10K+ employees
Learn more about CVS Healthexternal

$26.01 - $62.32/hr

Full-time

Medical, Dental, Vision, Retirement, PTO

This job post has expired today. Applications are no longer accepted.

CVS Health rating

5.8

Company rating: 5.8 out of 10

Based on 4,375 frontline employees who took The Breakroom Quiz

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.

Utilization Management Nurse Consultant Clinical Precertification RN (Medicare)

Remote | Full-Time | Weekday Schedule

Are you a Registered Nurse ready to make an impact beyond the bedside? Join our team and use your clinical expertise to ensure members receive the right care at the right time.

What You'll Do

Review clinical cases and make coverage determinations using evidence-based guidelines

Collaborate with providers and care teams to coordinate appropriate treatment

Apply clinical judgment to support utilization and benefit management decisions

Identify opportunities to improve care quality and member outcomes

Serve as a clinical resource across internal and external stakeholders

What You Bring - REQUIRED

Active, unrestricted RN license in the state of residence.

3+ years of RN experience, including 1+ year in Med/Surg

Strong clinical assessment and decision-making skills

Experience with Microsoft Office (Outlook, Teams, Excel)

Ability to work Monday-Friday, 9:00 AM-6:00pm PM in your time zone. Utilization Management is a 24/7 operation and work schedules will include holidays and evening hours

Associate Degree in Nursing

Nice to Have

Utilization Management or Prior Authorization experience

Managed care background

Familiarity with MedCompass

Ambulatory surgery experience

BSN preferred

Why Join Us?

Transition your clinical skills into a collaborative, non-bedside role

Make a meaningful impact on patient care and outcomes

Work in a supportive, team-driven environment

If you're passionate about combining clinical expertise with care coordination and healthcare quality, we'd love to hear from you!

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: 09/07/2026

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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