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Weekday 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-effective, and compliant care for PACE participants supported by IntusCare. This individual ...

SIHO Insurance Services, Inc.

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Utilization Management Nurse

Columbus, IN · On-site

Utilization Management Nurse Reports To: Manager of Utilization Management Brief Description of Duties: This position is reserved for a licensed Registered Nurse who will perform the Utilization ...

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Weekday Cvs Utilization Management Nurse information

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$39K

$89.5K

$163K

How much do weekday cvs utilization management nurse jobs pay per year?

As of Jun 26, 2026, the average yearly pay for weekday 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 are the key skills and qualifications needed to thrive as a Weekday CVS Utilization Management Nurse, and why are they important?

To thrive as a Weekday CVS Utilization Management Nurse, you need a valid RN license, strong clinical assessment skills, and experience in case management or utilization review. Familiarity with healthcare management software, insurance guidelines, and medical coding systems such as ICD-10 is typically required. Exceptional critical thinking, attention to detail, and effective communication help nurses advocate for appropriate patient care while collaborating with providers and payers. These skills ensure proper resource utilization, regulatory compliance, and optimal patient outcomes in a managed care setting.

What is the difference between Weekday Cvs Utilization Management Nurse vs Weekend Cvs Utilization Management Nurse?

AspectWeekday Cvs Utilization Management NurseWeekend Cvs Utilization Management Nurse
Work ScheduleMonday to Friday, standard business hoursWeekend shifts, typically Saturday and Sunday
CertificationsRN license, utilization review certification often preferredRN license, utilization review certification often preferred
Work EnvironmentOffice-based, healthcare setting, insurance companyOffice-based, healthcare setting, insurance company
Job ResponsibilitiesReview medical necessity, authorize services, coordinate careReview medical necessity, authorize services, coordinate care

The main difference between Weekday Cvs Utilization Management Nurse and Weekend Cvs Utilization Management Nurse lies in their work schedule. Both roles require similar certifications, responsibilities, and work environments, but the weekday nurse works during standard business hours, while the weekend nurse covers weekend shifts. Both positions are essential for continuous patient care and insurance operations.

What is a Weekday CVS Utilization Management Nurse?

A Weekday CVS Utilization Management Nurse is a registered nurse who works for CVS Health, focusing on evaluating the medical necessity, appropriateness, and efficiency of healthcare services provided to patients. This role involves reviewing patient cases, coordinating with healthcare providers, and ensuring that treatments and services meet established guidelines and insurance requirements. These nurses typically work regular weekday hours, rather than nights or weekends. They play a key role in helping patients receive appropriate care while also managing healthcare costs for the organization.

How does a Weekday CVS Utilization Management Nurse typically collaborate with physicians and case managers?

As a Weekday CVS Utilization Management Nurse, you will regularly interact with physicians and case managers to review patient care plans and ensure appropriate resource utilization. This role involves evaluating medical records, discussing treatment options, and providing clinical recommendations to support cost-effective, quality care. Effective communication and teamwork are essential, as you’ll serve as a bridge between clinical staff, patients, and administrative teams to coordinate authorizations and resolve coverage questions.
What cities are hiring for Weekday Cvs Utilization Management Nurse jobs? Cities with the most Weekday 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 Weekday Cvs Utilization Management Nurse jobs? States with the most job openings for Weekday Cvs Utilization Management Nurse jobs include:
Weekday Cvs Utilization Management Nurse jobs near you

Utilization Management Nurse

Integrated Community Living and Par

Allentown, PA

Full-time

Medical, Dental, Vision, Retirement, PTO

Posted 9 days ago

Job description

Benefits:
  • Employee discounts
  • Paid time off
  • 401(k) matching
  • Competitive salary
  • Dental insurance
  • Health insurance
  • Training & development
  • Vision insurance
  • Wellness resources

Benefits/Perks
  • Competitive Compensation
  • Great Work Environment
  • Career Advancement Opportunities
Job Summary
We are seeking a Utilization Management Nurse to join our team! As a Utilization Management Nurse on the team, you will be responsible for reviewing patient files and treatment methods with an eye for efficiency and effectiveness. Your role will be to ensure we are running at optimal efficiency, and that all patients under our care are receiving the necessary treatments and procedures. The ideal candidate has deep experience in a similar medical setting, has a bachelor's or higher in Nursing, and has a certification in either Case Management or Utilization Management.
Responsibilities
  • Review patient files and treatment information for efficiency
  • Monitor the activity of staff to ensure effective patient treatment
  • Advocate for quality patient care to prevent complications
  • Review discharge information for outgoing patients
  • Work closely with clinical staff to provide excellent patient care
  • Prepare reports on patient management and cost assessments
Qualifications
  • Nurse, with state LPN licensure, required
  • Certificate in Case Management or Utilization Management desired
  • Strong communication and interpersonal skills
  • Strong analytical skills