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Senior Cvs Utilization Management Nurse Jobs (NOW HIRING)

CVS Health

Utilization Management Nurse Consultant

$32.01 - $68.55/hr

Registered Nurse (RN) - Utilization Management Remote | Utilization Management | Work from Home Are ... This position is eligible for a CVS Health bonus, commission or short-term incentive program in ...

Oak St. Health

Utilization Management Nurse Consultant

$32.01 - $68.55/hr

CVS Health Utilization Management Position We're building a world of health around every individual ... Must have active current and unrestricted RN licensure in state of residence. Utilization ...

Oak St. Health

Utilization Management Nurse Consultant

$26.01 - $56.14/hr

CVS Health Utilization Management Position We're building a world of health around every individual ... Registered Nurse in adult acute care/critical care setting - Must have active current and ...

Oak St. Health

Utilization Management Nurse Consultant

$32.01 - $68.55/hr

CVS Health Utilization Management Position We're building a world of health around every individual ... Required Qualifications 2+ years of experience as a Registered Nurse in adult acute care/critical ...

HealthONE

Utilization Management Nurse

Dalton, GA · On-site

Job Title Utilization Management Nurse The Utilization Management Nurse performs comprehensive clinical reviews of requested services utilizing clinical criteria, received through various mechanisms.

Access Dubuque

Utilization Management Nurse

Dubuque, IA · On-site

Utilization Management Nurse Cottingham & Butler/ SISCO 1 Positions ID: 4627707008 Posted On 07/01/2025 Refreshed On 07/15/2026 Job Overview Utilization Management Nurse Location : Onsite in Dubuque ...

Intus Care

Contract Utilization Management Nurse

$42/hr

Contract Utilization Management Nurse IntusCare is the only end-to-end ecosystem built specifically to help Programs of All-Inclusive Care for the Elderly (PACE) programs deliver exceptional care ...

INTUS INC

Contract Utilization Management Nurse

$42/hr

Role Overview The Contract Utilization Management Nurse plays a critical role in ensuring high-quality, cost-effective, and compliant care for PACE participants supported by IntusCare. This ...

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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

Registered Nurse (RN) – Utilization Management

Remote | Utilization Management | Work from Home

Are you an experienced RN looking to leverage your clinical expertise in a non-bedside role? Join our Utilization Management team and help ensure members receive appropriate, high-quality care while improving healthcare outcomes across the continuum of care.

What You'll Do

  • Review clinical information and apply evidence-based criteria, policies, and clinical judgment to support coverage determinations
  • Assess, coordinate, monitor, and evaluate healthcare services and benefits for members
  • Collaborate with providers and care teams to facilitate appropriate treatment and care planning
  • Identify opportunities to improve healthcare quality, effectiveness, and utilization
  • Connect members with additional programs and services that support their overall health needs
  • Serve as a clinical resource for internal and external stakeholders

What You Bring - Required

  • Active, unrestricted RN license in your state of residence
  • 2+ years of adult acute care and/or critical care nursing experience
  • Strong clinical assessment, critical thinking, and communication skills
  • Ability to navigate multiple systems and work efficiently in a fast-paced environment
  • Associate Degree in Nursing required

Preferred Qualifications

  • 2+ years of Med-Surg or specialty nursing experience
  • Managed Care or Utilization Management experience
  • Reside in the Pacific or Mountain Time Zone
  • California RN License
  • BSN preferred

Schedule & Work Environment

  • Utilization Management operates 24/7
  • Schedule may include evenings, weekends, and holidays
  • Sedentary, computer-based role with productivity and quality expectations
  • Frequent collaboration with providers and internal healthcare teams

Why Join Us?

  • Transition your clinical expertise into a rewarding non-bedside nursing role
  • Make a meaningful impact on member care and healthcare outcomes
  • Work remotely while collaborating with a supportive clinical team
  • Grow your expertise in Utilization Management and Managed Care

If you're a detail-oriented RN with strong clinical judgment and a passion for improving patient outcomes, we'd love to hear from you. Apply today!

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.

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 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: 08/15/2026

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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