New York, NY · Remote
$29.10 - $62.32/hr
At CVS Health, you'll be surrounded by passionate colleagues who care deeply, innovate with purpose ... Utilization Management experience Education Associates Degree in Nursing required BSN preferred ...
New York, NY · Remote
$29.10 - $62.32/hr
At CVS Health, you'll be surrounded by passionate colleagues who care deeply, innovate with purpose ... Utilization Management experience Education Associates Degree in Nursing required BSN preferred ...
$80K - $95K/yr
Role Overview The Utilization Management Nurse plays a critical role in ensuring high-quality, cost ... Opportunities for professional growth and development Compensation : The salary range for this role ...
$80K - $95K/yr
Role Overview The Utilization Management Nurse plays a critical role in ensuring high-quality, cost ... Opportunities for professional growth and development Compensation : The salary range for this role ...
The ISNP Utilization Management Nurse is supervised by a Utilization Management Supervisor and is responsible for evaluating a member's clinical condition through the review of medical records ...
The ISNP Utilization Management Nurse is supervised by a Utilization Management Supervisor and is responsible for evaluating a member's clinical condition through the review of medical records ...
Oak Brook, IL · On-site +1
We have an innovative organization looking to add a Lead Utilization Management Nurse to its team ... At least 4-5 years of relevant professional experience, including medical management experience in ...
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Oak Brook, IL · On-site +1
We have an innovative organization looking to add a Lead Utilization Management Nurse to its team ... At least 4-5 years of relevant professional experience, including medical management experience in ...
Reporting to the Director of Utilization Management, the Utilization Management Nurse is responsible for ensuring that patients receive appropriate, cost-effective care by reviewing and evaluating ...
Reporting to the Director of Utilization Management, the Utilization Management Nurse is responsible for ensuring that patients receive appropriate, cost-effective care by reviewing and evaluating ...
Los Angeles, CA · On-site
$60 - $75/hr
As a Utilization Management Nurse on the team, you will be responsible for reviewing patient files ... Knowledge of professional nursing practice and the ability to apply the nursing process (assessment ...
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Los Angeles, CA · On-site
$60 - $75/hr
As a Utilization Management Nurse on the team, you will be responsible for reviewing patient files ... Knowledge of professional nursing practice and the ability to apply the nursing process (assessment ...
Reporting to the Director of Utilization Management, the Utilization Management Nurse is responsible for ensuring that patients receive appropriate, cost-effective care by reviewing and evaluating ...
Reporting to the Director of Utilization Management, the Utilization Management Nurse is responsible for ensuring that patients receive appropriate, cost-effective care by reviewing and evaluating ...
Reporting to the Director of Utilization Management, the Utilization Management Nurse is responsible for ensuring that patients receive appropriate, cost-effective care by reviewing and evaluating ...
Reporting to the Director of Utilization Management, the Utilization Management Nurse is responsible for ensuring that patients receive appropriate, cost-effective care by reviewing and evaluating ...
The Utilization Management Nurse is responsible for the monitoring patient plan of care for timely completion and efficient use of resources by facilitating diagnostic and treatment services, tests ...
The Utilization Management Nurse is responsible for the monitoring patient plan of care for timely completion and efficient use of resources by facilitating diagnostic and treatment services, tests ...
The Utilization Management Nurse performs medical necessity and benefit review requests in accordance with national standards, contractual requirements, and a member's benefit coverage while working ...
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The Utilization Management Nurse performs medical necessity and benefit review requests in accordance with national standards, contractual requirements, and a member's benefit coverage while working ...
Chapel Hill, NC · On-site +1
The Utilization Management Nurse performs medical necessity and benefit review requests in accordance with national standards, contractual requirements, and a member's benefit coverage while working ...
Chapel Hill, NC · On-site +1
The Utilization Management Nurse performs medical necessity and benefit review requests in accordance with national standards, contractual requirements, and a member's benefit coverage while working ...
Columbus, IN · On-site
Utilization Management Nurse Reports To: Manager of Utilization Management Employment Type ... Act and perform within the scope of professional nursing practice; display responsibility in ...
Columbus, IN · On-site
Utilization Management Nurse Reports To: Manager of Utilization Management Employment Type ... Act and perform within the scope of professional nursing practice; display responsibility in ...
Utilization Management Nurse Reports To: Manager of Utilization Management Employment Type ... Act and perform within the scope of professional nursing practice; display responsibility in ...
Utilization Management Nurse Reports To: Manager of Utilization Management Employment Type ... Act and perform within the scope of professional nursing practice; display responsibility in ...
Utilization Management Nurse Reports To: Manager of Utilization Management Employment Type ... professional nursing practice; is responsible in supporting and participating in department ...
Quick apply
Utilization Management Nurse Reports To: Manager of Utilization Management Employment Type ... professional nursing practice; is responsible in supporting and participating in department ...
The Utilization Management Nurse is responsible for the monitoring patient plan of care for timely completion and efficient use of resources by facilitating diagnostic and treatment services, tests ...
The Utilization Management Nurse is responsible for the monitoring patient plan of care for timely completion and efficient use of resources by facilitating diagnostic and treatment services, tests ...
Be Seen First
Columbus, IN · On-site
Job Title: Utilization Management Nurse Reports To: Manager of Utilization Management Brief ... Act and perform within the scope of professional nursing practice; display responsibility in ...
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Be Seen First
Columbus, IN · On-site
Job Title: Utilization Management Nurse Reports To: Manager of Utilization Management Brief ... Act and perform within the scope of professional nursing practice; display responsibility in ...
Utilization Management Nurse Location : Onsite in Dubuque, IA. Also accepting remote applicants. We ... professional office setting with daytime office hours and weekends/holidays off. This position is ...
Utilization Management Nurse Location : Onsite in Dubuque, IA. Also accepting remote applicants. We ... professional office setting with daytime office hours and weekends/holidays off. This position is ...
Oak Brook, IL · On-site
$35.50 - $53.25/hr
Typically requires 3 years of experience in clinical nursing, utilization and/or quality management ... Promotes effective professional relationships with physicians and other professionals in a direct ...
Oak Brook, IL · On-site
$35.50 - $53.25/hr
Typically requires 3 years of experience in clinical nursing, utilization and/or quality management ... Promotes effective professional relationships with physicians and other professionals in a direct ...
Utilization Management Nurse Location : Onsite in Dubuque, IA. Also accepting remote applicants. We ... professional office setting with daytime office hours and weekends/holidays off. This position is ...
New
Quick apply
Utilization Management Nurse Location : Onsite in Dubuque, IA. Also accepting remote applicants. We ... professional office setting with daytime office hours and weekends/holidays off. This position is ...
New
Utilization Management Nurse Location : Onsite in Dubuque, IA. Also accepting remote applicants. We ... professional office setting with daytime office hours and weekends/holidays off. This position is ...
New
Quick apply
Utilization Management Nurse Location : Onsite in Dubuque, IA. Also accepting remote applicants. We ... professional office setting with daytime office hours and weekends/holidays off. This position is ...
New
$21.39 - $25.72
2% of jobs
$25.72 - $30.05
9% of jobs
$33.01 is the 25th percentile. Wages below this are outliers.
$30.05 - $34.38
21% of jobs
The median wage is $37.88 / hr.
$34.38 - $38.70
23% of jobs
$38.70 - $43.03
13% of jobs
$46.39 is the 75th percentile. Wages above this are outliers.
$43.03 - $47.36
10% of jobs
$47.36 - $51.68
8% of jobs
$51.68 - $56.01
5% of jobs
$56.01 - $60.34
5% of jobs
$60.34 - $64.66
2% of jobs
$64.66 - $68.99
2% of jobs
$21
$42
$68
| Aspect | Professional Cvs Utilization Management Nurse | Utilization Review Nurse |
|---|---|---|
| Credentials | RN license, certifications in case management or utilization review | RN license, certifications in case management or utilization review |
| Work Environment | Hospitals, insurance companies, healthcare organizations | Insurance companies, healthcare facilities, third-party review organizations |
| Employer & Industry Usage | Primarily in cardiovascular-focused healthcare settings and insurance | Broader healthcare insurance and managed care settings |
The Professional Cvs Utilization Management Nurse specializes in managing cardiovascular cases within utilization review, often focusing on cardiac-related treatments. The Utilization Review Nurse has a broader scope, handling various medical cases across different specialties. Both roles require similar credentials and work environments but differ in their specific focus areas within healthcare and insurance industries.
$29.10 - $62.32/hr
Full-time
Medical, Dental, Vision, Retirement, PTO
Posted 3 days ago
5.8
Based on 4,317 frontline employees who took The Breakroom Quiz
88th of 109 rated pharmacies
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 is a 24/7 operation and work schedule may include weekends, holidays, and evening hours.
UM Nurse Consultant
Fully Remote- WFH
Schedule : Tuesday-Saturday 9:30am-6:00pm
Position Summary:
UM Nurse Consultant
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
-Must have 3+ years of Med Surg experience as an RN in the hospital setting
- Active and unrestricted RN licensure in state of residence
- Able to work in multiple IT platforms/systems
- 1+ years of experience with Microsoft Office Applications (Outlook, Teams, Excel)
Preferred Qualifications
- Knowledge of Medicare/Medicaid
- Managed care experience
- Utilization Management experience
Education
Associates Degree in Nursing required
BSN preferred
Anticipated Weekly Hours
40Time Type
Full timePay Range
The typical pay range for this role is:
$29.10 - $62.32This 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.
Additional details about available benefits are provided during the application process and on Benefits Moments.
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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Health care and social assistance and retail
10,000+ Employees
Woonsocket, RI, US
