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Remote Cvs Utilization Management Nurse Jobs (NOW HIRING)

Intus, Inc

Utilization Management Nurse

$80K - $95K/yr

Role Overview The Utilization Management Nurse plays a critical role in ensuring high-quality, cost ... This is a fully remote role based in the United States. Sponsorship: This position is not eligible ...

Dignity Health Management Services

$57.37 - $85.33/hr

As a remote employee, we will provide you with the equipment needed to work from home, including a ... Bachelors of Nursing (BSN) preferred * Previous inpatient Utilization Management (UM) experience ...

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Elevance Health

Med Mgmt Clinician Sr (contract)

Atlanta, GA · Remote

$27 - $34.50/hr

May complete quality audits and assist management with developing associated corrective action ... and/or utilization review experience. * Current active, valid and unrestricted LPN/LVN or RN ...

Elevance Health

Med Mgmt Clinician Sr (contract)

Atlanta, GA · Remote

$27 - $34.50/hr

May complete quality audits and assist management with developing associated corrective action ... and/or utilization review experience. * Current active, valid and unrestricted LPN/LVN or RN ...

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How much do remote cvs utilization management nurse jobs pay per hour?

As of Jul 23, 2026, the average hourly pay for remote cvs utilization management nurse in the United States is $42.28, according to ZipRecruiter salary data. Most workers in this role earn between $33.41 and $48.56 per hour, depending on experience, location, and employer.

What is the difference between Remote Cvs Utilization Management Nurse vs Remote Cvs Case Manager?

AspectRemote Cvs Utilization Management NurseRemote Cvs Case Manager
CredentialsRN license, certifications in utilization reviewRN license, case management certification
Work EnvironmentUtilization review teams, insurance companiesPatient advocacy, care coordination teams
Employer & IndustryHealth insurance, managed care organizationsHealth insurance, healthcare providers

Both roles require RN licensure and related certifications, but the Utilization Management Nurse focuses on reviewing medical necessity and approving services, while the Case Manager emphasizes coordinating patient care and discharge planning. Understanding these differences helps job seekers find the right fit within the healthcare and insurance industries.

More about Remote Cvs Utilization Management Nurse jobs
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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 Remote Cvs Utilization Management Nurse jobs? States with the most job openings for Remote Cvs Utilization Management Nurse jobs include:
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Remote Cvs Utilization Management Nurse jobs near you
Infographic showing various Remote Cvs Utilization Management Nurse job openings in the United States as of July 2026, with employment types broken down into 50% Full Time, 45% Part Time, 4% Contract, and 1% Summer. Highlights an 96% Physical, 1% Hybrid, and 3% Remote job distribution, with an average salary of $87,946 per year, or $42.3 per hour.
Utilization Management Nurse Consultant

Utilization Management Nurse Consultant

CVS Health

New York, NY • Remote

$29.10 - $62.32/hr

Full-time

Medical, Dental, Vision, Retirement, PTO

Posted 29 days ago

CVS Health rating

5.8

Company rating: 5.8 out of 10

Based on 4,294 frontline employees who took The Breakroom Quiz

80th of 104 rated pharmacies

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 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

40

Time Type

Full time

Pay Range

The typical pay range for this role is:

$29.10 - $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: 07/23/2026

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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