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Part Time Cvs Utilization Management Nurse Jobs (NOW HIRING)

silvercross

Utilization Review Nurse

New Lenox, IL

$34.73 - $45.15/hr

Relevant hospital nursing; hospital case management; insurance case management or utilization ... Part-time employees which includes: Medical, Dental and Vision plans Life Insurance Flexible ...

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Part Time Cvs Utilization Management Nurse information

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$39K

$89.5K

$163K

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

As of Aug 14, 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.

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The most popular types of Cvs Utilization Management Nurse jobs are:

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Part Time Cvs Utilization Management Nurse jobs near you

RN Case Manager - Utilization Management - Part Time

Augusta Health

Fishersville, VA • On-site

Part-time

Medical, Retirement, PTO

Posted 9 days ago

Augusta Health rating

6.6

Company rating: 6.6 out of 10

Based on 47 frontline employees who took The Breakroom Quiz

680th of 1,059 rated hospitals

Job description

The Utilization Review RN Case Manager applies knowledge of medical necessity criteria and regulatory requirements in determining the appropriate patient status for any person destined for a bed on the patient care units. This position works closely with admitting and attending providers as well as the Utilization Management Physician Advisor to ensure patient status is accurate and compliant with regulatory standards. The Utilization Review RN Case Manager is viewed by clinical teams as an expert in the building when it comes to selecting the appropriate level of service for patients. They participate in multidisciplinary discharge rounds on the hospital units to understand clinical course, discharge plans and possible changes in medical necessity, all toward selecting the levels of care that match clinical necessity. This position plays an essential role in securing reimbursement to the hospital for services provided by commercial, Medicaid and Medicare payers through timely communication and submission of relevant clinical information to the payer when required. The effective tending of utilization review lowers the frequency of avoidable denials by payers for services provided. This role ensures adherence to the policies and guidelines of all payer review organizations to secure appropriate reimbursement for patient hospitalizations. During normal business hours this position may screen patients to determine if case management follow-up is required.
Minimum Qualifications
  • Bachelor of Science in Nursing
    OR
  • Associate's degree in Nursing PLUS three years of experience as an RN
  • Registered nurse license in the Commonwealth of Virginia or from a state that is part of a compact agreement with Virginia
  • Acute care hospital experience or comparable job-related experience in at least 3 of the last 5 years

Preferred Qualifications
  • National certification in case management or utilization management preferred
  • 3 to 5 years of recent experience in utilization review and/or discharge planning in an acute care setting preferred

Skills
  • Comprehensive knowledge of regulatory, legislative, and DNV standards related to utilization review.
  • Proficient in computer skills including navigating EHRs, medical necessity criteria, Microsoft Office products.
  • Effective verbal and written skills with the ability to collaborate with multiple disciplines throughout the organization.
  • Good problem solving and decision-making skills.
  • Excellent organizational skills and the ability to work in a fast-paced environment.

Some benefits of working at Augusta Health include
  • Healthcare Benefits
  • Generous paid time off
  • Retirement savings helping you to plan for your future
  • Free onsite parking
  • 24/7 armed security to ensure your safety
  • Tuition reimbursement
  • Onsite child care
  • Augusta Health Fitness Reimbursement Program
  • Onsite credit union
  • Employee discounts including the cafeteria, gift shop, pharmacy, and movie tickets

Company Information
Augusta Health is a mission-driven, independent, nonprofit, community health system located in Fishersville Virginia in Virginia's scenic Shenandoah Valley. Augusta Health offers a full continuum of inpatient and outpatient which includes Augusta Medical Center a 255 bed inpatient facility and Augusta Medical Group which is comprised of 40 practice locations and four urgent care locations.
Equal Opportunity
Augusta Health recruits, hires and promotes qualified candidates for employment without regard to age, color, disability, gender identity or expression, marital status, national or ethnic origin, political affiliation, race, religion, sex (including pregnancy), sexual orientation, veteran or military discharge status, and family medical or genetic information.
Equal Opportunity Employer
This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor.

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