Remote job Utilization Management Nurse Consultant (Remote), Anywhere-id-9199

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Now Hiring: Utilization Management Nurse Consultant (Remote)
Job ID: R0614229
đź“Ť Location: 100% Remote (U.S. based only)
📅 Schedule: Monday–Friday, 11:30 AM–8:00 PM EST (may vary slightly depending on business needs)

Your Role at CVS Health

At CVS Health, we’re reimagining the way healthcare works for millions of Americans. With over 300,000 compassionate colleagues and a nationwide reach, we’re committed to making care more connected, convenient, and human. We’re currently looking for a Utilization Management (UM) Nurse Consultant to join our virtual team with American Health Holding, Inc. (AHH)—a URAC-accredited medical management division of CVS Health.

This position is perfect for an experienced RN who thrives in a remote, fast-paced, and clinically focused environment.

What You’ll Do

As a UM Nurse Consultant, you’ll:

This Role is 100% Remote

To be successful, you’ll need:

  • A quiet, professional workspace free from distractions.

  • Child/dependent care arranged outside of working hours.

  • Strong focus and discipline while working independently.

  • Availability for a mandatory 3-week training (Monday–Friday, 8:30 AM–5:00 PM EST).

What You Bring

âś… Required:

  • Active, unrestricted RN license in your home state with compact/multistate privileges.

  • Ability to obtain licensure in other states if needed.

  • 5+ years of nursing experience, with 3+ years in acute care, LTAC, or skilled nursing.

  • 1+ year of UM experience (in prior authorization, concurrent review, or inpatient/outpatient utilization).

  • Strong critical thinking, clinical judgment, and decision-making ability.

  • Comfortable using phones, EMR systems, and juggling multiple software platforms.

🌟 Preferred:

  • Experience working in a Managed Care Organization (MCO).

  • Familiarity with high-volume call centers or remote care settings.

  • BSN preferred (Associate’s degree required).

Pay & Hours

  • Full-Time | 40 hours/week

  • Pay Range: $29.10 – $62.32/hour
    (Exact rate based on experience, location, and other factors.)

  • Eligible for CVS Health bonus or incentive programs.

Benefits That Take Care of You

We offer a wide range of benefits designed to support your total well-being:

  • Competitive medical plans, 401(k) with company match, stock purchase options

  • Generous PTO, flexible scheduling, and paid family leave

  • Wellness resources, free coaching, and mental health support

  • Tuition assistance and career development programs
    ➡️ Full benefits overview here

Diversity & Inclusion at CVS Health

We’re proud of our inclusive culture where every colleague feels respected, heard, and supported. We welcome applicants from all backgrounds, including those with prior arrests or convictions, in accordance with federal and state laws.

Application Deadline:

đź—“ Apply by July 31, 2026

Apply today to join a team that’s passionate about transforming healthcare—and delivering it with heart.

Remote job Utilization Management Nurse Consultant (Remote), Anywhere-id-9199

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