Utilization Management Nurse (RN) - 24/7 OperationsLocation: Remote (Preference for CST/MT time zones)
Schedule: Includes evenings, weekends, and holidays
Are you a detail-oriented RN with a passion for improving patient outcomes and healthcare efficiency? Join our Utilization Management team and play a key role in ensuring members receive the right care at the right time.
What You'll Do- Review clinical information and apply guidelines to make coverage determinations across the care continuum
- Collaborate with providers and internal teams to coordinate care and support treatment plans
- Identify opportunities to enhance quality, efficiency, and member outcomes
- Refer members to appropriate programs, services, and resources
- Serve as a clinical expert in utilization and benefit management
What You Bring - Required- Active, unrestricted RN license in your state of residence
- 2+ years of recent experience in adult acute or critical care
- Strong clinical judgment, communication, and multitasking skills
- Comfort working in a fast-paced, technology-driven environment
- Associates Degree in Nursing
Preferred Qualifications- Experience in Med-Surg or a specialty clinical area
- Managed care or Utilization Management experience
- BSN preferred
- Residence in CST or MT time zone
Work Environment- Remote, sedentary role with frequent computer and phone use
- Requires attention to detail, productivity, and quality standards
Anticipated Weekly Hours40
Time TypeFull time
Pay RangeThe typical pay range for this role is:
$26.01 - $56.14
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 peopleWe 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: 07/11/2026
