• Utilization Management

    CVS Health (Woonsocket, RI)
    …all with heart, each and every day. **Position Summary:** The ** Utilization Management Clinical Nurse Consultant - Prior Authorization** utilizes ... internal and external constituents in the coordination and administration of the utilization /benefit management function. + Gathers clinical information and… more
    CVS Health (10/26/25)
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  • Behavioral Health Utilization

    CVS Health (Oklahoma City, OK)
    …a psychiatric or behavioral health setting required. + Strong knowledge of clinical practice guidelines and utilization management . **Required** ... clinical skills to coordinate, document, and communicate all aspects of our utilization and benefit management programs. You'll apply critical thinking and… more
    CVS Health (10/18/25)
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  • Utilization Management

    CVS Health (Richmond, VA)
    …internal and external constituents in the coordination and administration of the utilization /benefit management function. + Gathers clinical information and ... skills to coordinate, document, and communicate all aspects of the utilization /benefit management program. + Applies critical thinking and knowledge in… more
    CVS Health (10/26/25)
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  • Utilization Management Nurse…

    CVS Health (Carson City, NV)
    …(UM) Nurse Consultant . As a Utilization Management Nurse Consultant , you will utilize clinical skills to coordinate, document and communicate all ... clinical records. **Key Responsibilities of the UM Nurse Consultant ** (Includes but is not limited to) + Reviews...practice experience as an RN required. + 2+ Years Utilization Management experience. + Must be willing… more
    CVS Health (10/25/25)
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  • Utilization Management Appeals Nurse…

    CVS Health (Columbus, OH)
    …resolving clinical complaints and appeals by reviewing medical records and applying clinical guidelines for Utilization Management group. This RN must be ... high-quality healthcare for members. We are seeking a dedicated Utilization Management (UM) Nurse to join our...3+ years Utilization Management or Utilization Review experience. + 3+ years clinical more
    CVS Health (10/12/25)
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  • Utilization Management Nurse…

    CVS Health (Richmond, VA)
    …And we do it all with heart, each and every day. **Position Summary** This Utilization Management Nurse Consultant (UMNC) position is 100% remote. As a ... Utilization Nurse Consultant , you will utilize clinical skills to...to coordinate, document and communicate all aspects of the utilization /benefit management program and our plan sponsor(s).… more
    CVS Health (10/24/25)
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  • Utilization Management Nurse…

    CVS Health (Atlanta, GA)
    …all with heart, each and every day. **Position Summary** Medicare Predetermination Utilization Management Nurse Consultant position: _Utilization ... with occasional holiday rotation.** **Preferred Qualifications** + Prior Authorization or Utilization Management experience + Managed care experience +… more
    CVS Health (10/22/25)
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  • Utilization Management Nurse…

    CVS Health (Topeka, KS)
    …Must have active current and unrestricted RN licensure in state of residence - Utilization Management is a 24/7 operation and work schedules will include ... in med surg or specialty area - Managed Care experience preferred, especially Utilization Management - Preference for those residing in Central Time zones… more
    CVS Health (10/26/25)
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  • Utilization Management Nurse…

    CVS Health (Phoenix, AZ)
    …a difference in the lives of patients facing complex medical journeys. As a Utilization Management (UM) Nurse Consultant specializing in Oncology and ... Inc. (AHH), a division of Aetna/CVS Health, is a URAC-accredited medical management organization founded in 1993. We provide flexible, cost-effective care … more
    CVS Health (10/01/25)
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  • NICU/Spine | Utilization Management

    CVS Health (Springfield, IL)
    …time is spent at a desk and on the phone collecting and reviewing clinical information from providers. Utilization Management nurses use specific criteria ... paced environment NICU experience 3+ years **Preferred Qualifications** Previous Utilization Management experience Spine Experience **Education** Associates… more
    CVS Health (10/16/25)
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