- Specialty: Utilization Review
- Job type: Full-time
- Salary: $71,100 – $97,800 / yr
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This role is no longer accepting applications.
CVS Health closed this listing in September 2026. The listing stays up for reference — the roles below are open right now.
At a glance
Remote RN utilization review for post-acute services at CVS Health. Evaluates medical necessity for SNF, IRF, LTACH, and home health authorizations using clinical criteria. Requires an active RN license, 3+ years clinical experience, and 1+ years in UM or related areas.
This position is responsible for performing utilization management (UM) reviews and authorization activities for post-acute services, including Skilled Nursing Facilities (SNF), Inpatient Rehabilitation Facilities (IRF), Long-Term Acute Care Hospitals (LTACH), Home Health, and other post-acute levels of care. The UM Nurse Consultant evaluates medical necessity and appropriateness of services utilizing clinical criteria, applicable policies, and regulatory requirements to support quality, cost-effective care.
The UM Nurse Consultant collaborates with providers, care managers, medical directors, and interdisciplinary teams to facilitate timely care transitions, ensure member needs are met, and support organizational goals. This role requires independent clinical judgment, strong critical thinking skills, and the ability to manage multiple priorities in a fast-paced environment.
More open utilization review positions — or browse every utilization review role.
40
Full time
$26.01 - $56.14
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