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Senior Cvs Utilization Management Nurse Jobs (NOW HIRING)

CVS Health

Utilization Management Nurse Consultant

$32.01 - $68.55/hr

Utilization Management Nurse Consultant We're building a world of health around every individual ... At CVS Health ® , you'll be surrounded by passionate colleagues who care deeply, innovate with ...

CVS Health

Utilization Management Nurse Consultant

$26.01 - $56.14/hr

At CVS Health ® , you'll be surrounded by passionate colleagues who care deeply, innovate with ... N licensure in state of residence - Utilization Management is a 24/7 operation and work schedules ...

CVS Health

MI · On-site

$26.01 - $68.55/hr

At CVS Health ® , you'll be surrounded by passionate colleagues who care deeply, innovate with ... As a Utilization Management Nurse Consultant, you will utilize clinical skills to coordinate ...

Oak St. Health

Utilization Management Nurse Consultant

$26.01 - $68.55/hr

At CVS Health ® , you'll be surrounded by passionate colleagues who care deeply, innovate with ... Utilization Management is a 24/7 operation and work schedule may include weekends, holidays, and ...

CVS Health

Utilization Management Nurse Consultant

Home, PA · On-site

$29.10 - $62.32/hr

At CVS Health ® , you'll be surrounded by passionate colleagues who care deeply, innovate with ... N licensure in state of residence * Utilization Management is a 24/7 operation and work schedules ...

CVS Health

Utilization Management Nurse Consultant

$32.01 - $68.55/hr

Registered Nurse (RN) - Utilization Management Join a dynamic healthcare team and make an impact on ... This position is eligible for a CVS Health bonus, commission or short-term incentive program in ...

Oak St. Health

Utilization Management Nurse Consultant

$26.01 - $68.55/hr

At CVS Health ® , you'll be surrounded by passionate colleagues who care deeply, innovate with ... Utilization Management is a 24/7 operation and work schedule may include weekends, holidays, and ...

CVS Health

Utilization Management Nurse Consultant

$32.01 - $68.55/hr

Registered Nurse (RN) - Utilization Management Join a dynamic healthcare team where your clinical ... This position is eligible for a CVS Health bonus, commission or short-term incentive program in ...

CVS Health

Utilization Management Nurse Consultant

Home, KS · On-site

$26.01 - $56.14/hr

At CVS Health ® , you'll be surrounded by passionate colleagues who care deeply, innovate with ... N licensure in state of residence * Utilization Management is a 24/7 operation and work schedules ...

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Senior Cvs Utilization Management Nurse information

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

As of Aug 8, 2026, the average hourly pay for senior 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 Senior Cvs Utilization Management Nurse vs Cardiology Nurse?

AspectSenior Cvs Utilization Management NurseCardiology Nurse
CredentialsRN license, certification in case management or utilization reviewRN license, cardiology-specific certifications (e.g., Cardiac Vascular Nursing Certification)
Work EnvironmentUtilization review departments, insurance companies, hospitalsCardiology units, hospitals, outpatient clinics
Primary ResponsibilitiesReviewing patient cases for appropriate resource use, ensuring insurance complianceProviding direct patient care, monitoring cardiac conditions, patient education
Industry UsageHealthcare insurance, hospital administrationHospitals, cardiology clinics, outpatient facilities

The Senior Cvs Utilization Management Nurse focuses on reviewing and managing patient care from a resource and insurance perspective, while the Cardiology Nurse provides direct cardiac patient care. Both roles require RN licensure, but their work environments and responsibilities differ significantly.

What cities are hiring for Senior Cvs Utilization Management Nurse jobs? Cities with the most Senior 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 Senior Cvs Utilization Management Nurse jobs? States with the most job openings for Senior Cvs Utilization Management Nurse jobs include:
Senior Cvs Utilization Management Nurse jobs near you

Utilization Management Nurse Consultant

CVS Health

Remote

$32.01 - $68.55/hr

Other

Medical, Dental, Vision, Retirement, PTO

Re-posted 10 days ago

CVS Health rating

5.8

Company rating: 5.8 out of 10

Based on 4,330 frontline employees who took The Breakroom Quiz

89th of 112 rated pharmacies

Job description

Utilization Management Nurse Consultant

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 ourselves accountable 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.

Position Summary

Utilization Management is a 24/7 operation and work schedule may include weekends, holidays and evening hours.

As a Utilization Management Nurse Consultant, you will utilize clinical skills to coordinate, document and communicate all aspects of the utilization/benefit management program.

- Utilizes clinical skills to coordinate, document and communicate all aspects of the utilization/benefit management program. Applies critical thinking and knowledge in clinically appropriate treatment, evidence-based care and medical necessity criteria for appropriate utilization of services.

- Consults and lends expertise to other internal and external constituents in the coordination and administration of the utilization/benefit management function.

- Gathers clinical information and applies the appropriate medical necessity criteria/guideline, policy, procedure and clinical judgement to render coverage determination/recommendation/discharge planning along the continuum of care.

- Utilizes clinical experience and skills in a collaborative process to evaluate and facilitate appropriate healthcare services/benefits for members including urgent or emergent interventions (such as triage/crisis support).

- Coordinates/Communicates with providers and other parties to facilitate optimal care/treatment.

- Identifies members who may benefit from care management programs and facilities referrals.

- Identifies opportunities to promote quality effectiveness of healthcare services and benefit utilization

Required Qualifications

- Must have active, current, and unrestricted RN licensure in state of residence

- Willingness to obtain additional state licenses

- 3+ years of clinical practice experience in an inpatient setting as an RN

- 1+ years of experience with computer skills which includes navigating multiple systems and keyboarding

Preferred Qualifications

- Knowledge or clinical practice experience in a post acute facility ( Skilled nursing, Rehabilitation, Long Term Acute Care)

-Active IL RN Licensure

Education Associates degree required

BSN preferred

Anticipated Weekly Hours

40

Time Type

Full time

Pay Range

The typical pay range for this role is:

$32.01 - $68.55

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.

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 full‑time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial well‑being 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: 08/09/2026

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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