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Part Time Cvs Utilization Management Nurse Jobs (NOW HIRING)

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Summary : The RN - Case Management will be utilized as either Utilization Management or as ... Regular-Part time Shift : First Shift (United States of America)

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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 Sep 3, 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

Part Time Utilization Specialist

Crestwyn Behavioral Health

Memphis, TN

Part-time

Re-posted 14 days ago

Job description

Overview

PURPOSE STATEMENT: 

Proactively monitor utilization of services for patients to optimize reimbursement for the facility.  

Responsibilities

ESSENTIAL FUNCTIONS: 

  • Act as liaison between managed care organizations and the facility professional clinical staff. 
  • Conduct reviews, in accordance with certification requirements, of insurance plans or other managed care organizations (MCOs) and coordinate the flow of communication concerning reimbursement requirements. 
  • Monitor patient length of stay and extensions and inform clinical and medical staff on issues that may impact length of stay.  
  • Gather and develop statistical and narrative information to report on utilization, non-certified days (including identified causes and appeal information), discharges and quality of services, as required by the facility leadership or corporate office. 
  • Conduct quality reviews for medical necessity and services provided.   
  • Facilitate peer review calls between facility and external organizations.  
  • Initiate and complete the formal appeal process for denied admissions or continued stay.  
  • Assist the admissions department with pre-certifications of care.  
  • Provide ongoing support and training for staff on documentation or charting requirements, continued stay criteria and medical necessity updates. 

OTHER FUNCTIONS:  

  • Perform other functions and tasks as assigned. 
Qualifications

EDUCATION/EXPERIENCE/SKILL REQUIREMENTS: 

  • Required Education: High school diploma or equivalent. 
  • Preferred Education: Associate's, Bachelor's, or Master's degree in Social Work, Behavioral or Mental Health, Nursing, or a related health field. 
  • Experience: Clinical experience is required, or two or more years' experience working with the facility's population. Previous experience in utilization management is preferred 

LICENSES/DESIGNATIONS/CERTIFICATIONS:  

  • Preferred Licensure: LPN, RN, LMSW, LCSW, LPC, LPC-I within the state where the facility provides services; or current clinical professional license or certification, as required, within the state where the facility provides services. 
  • CPR and de-escalation and restraint certification required (training available upon hire and offered by facility.   
  • First aid may be required based on state or facility requirements. 

 

ADDITIONAL REGULATORY REQUIREMENTS: 

While this job description is intended to be an accurate reflection of the requirements of the job, management reserves the right to add or remove duties from particular jobs when circumstances  (e.g. emergencies, changes in workload, rush jobs or technological developments) dictate. 

We are committed to providing equal  employment opportunities to all applicants for employment regardless of an individual's characteristics protected by applicable state, federal and local laws.

Employment Type: PART_TIME

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