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Part Time Cvs Utilization Management Nurse Jobs (NOW HIRING)

Astrana Health, Inc.

$250K - $325K/yr

Medical Director - Utilization Management (Part Time) Department: HS - UM Employment Type ... Partner with Outpatient Medical Directors, Population Health, and UM nursing teams to align ...

Astrana Health

$250K - $325K/yr

Medical Director - Utilization Management (Part Time) The Part-Time Medical Director - Utilization ... Partner with Outpatient Medical Directors, Population Health, and UM nursing teams to align ...

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$39K

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

As of May 28, 2026, the average yearly pay for part 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 Part Time Cvs Utilization Management Nurse vs Part Time Cvs Case Management Nurse?

AspectPart Time Cvs Utilization Management NursePart Time Cvs Case Management Nurse
CertificationsRN license, Utilization Review Certification (if applicable)RN license, Case Management Certification (e.g., CCM)
Work EnvironmentUtilization review departments, insurance companies, healthcare facilitiesPatient care coordination, hospitals, clinics
Employer & Industry UsageInsurance providers, healthcare organizationsHospitals, healthcare systems, community clinics

While both roles require RN licensure and involve patient or healthcare management, the Utilization Management Nurse focuses on reviewing medical necessity and insurance approvals, whereas the Case Management Nurse coordinates patient care and discharge planning. Understanding these differences helps job seekers identify the right role based on their skills and career goals.

What cities are hiring for Part Time Cvs Utilization Management Nurse jobs? Cities with the most Part 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 Part Time Cvs Utilization Management Nurse jobs? States with the most job openings for Part Time Cvs Utilization Management Nurse jobs include:
Part Time Cvs Utilization Management Nurse jobs near you
RN, Utilization Management | Utilization Management

RN, Utilization Management | Utilization Management

UF Health

Gainesville, FL

Part-time

Posted 5 days ago

Job description

Overview

RN, Utilization Management | Utilization Management 

Ensure the right care at the right time—driving quality outcomes through effective utilization and care coordination.

???? Work Style: Onsite
???? Location: Gainesville, FL 
???? FTE: Part-Time (.6)
????️ Schedule: Weekend Only (12-hour shifts)

Evaluates patient medical records to determine the medical necessity and appropriateness of healthcare services in alignment with utilization management guidelines. Collaborates with healthcare providers to support compliance, optimize treatment plans, and promote efficient resource utilization.

Communicates authorization decisions clearly and monitors patient progress to support timely discharge planning. Analyzes utilization data to identify trends and opportunities for improvement.

Partners with interdisciplinary teams to enhance care coordination, ensure accurate documentation, and maintain compliance with regulatory and organizational standards.


Responsibilities

Key Responsibilities

  • Evaluates patient medical records to ensure the necessity and appropriateness of healthcare services.
  • Coordinates with healthcare providers to ensure compliance with utilization management guidelines.
  • Supports the optimization of treatment plans to promote effective patient care and appropriate resource utilization.
  • Communicates authorization decisions clearly and supports timely discharge planning.
  • Analyzes utilization data to identify trends and opportunities to improve care coordination.
  • Collaborates with interdisciplinary teams to ensure accurate documentation and regulatory compliance.

Qualifications

Education & Experience:


Registered Nurse (RN) with a current Florida license required.

  • Three (3) years of critical care nursing experience, or
  • Five (5) years of medical-surgical nursing experience, or
  • Three (3) years of utilization review, case management, or third-party payer experience.

Qualifications

  • Active Registered Nurse (RN) license with 3+ years of experience in utilization review or case management.
  • Strong knowledge of healthcare utilization management guidelines and regulatory compliance.
  • Experience evaluating medical necessity and optimizing treatment plans.
  • Excellent communication skills with the ability to clearly convey authorization decisions.
  • Ability to analyze utilization data and support effective care coordination.
  • Strong organizational skills with the ability to manage multiple priorities simultaneously.
  • Ability to work independently and collaboratively with multidisciplinary teams.
  • Strong attention to detail and innovative problem-solving skills.
  • Flexibility to adjust work hours and days based on departmental needs.

Motor Vehicle Operator Designation:
Employees in this position will not operate vehicles for an assigned business purpose.

Note: Please indicate the appropriate operator designation on the Request for Personnel (RFP) form at the time of submission.

Licensure/Certification/Registration:

  • Registered Nurse (RN) with a current Florida license required.

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