Utilization Management Nurse Consultant (UM) - Work at Home CST Zone

Utilization Management (UM) Nurse Consultant role with CVS Health, fully remote for CST zone residents. You will apply clinical expertise to ensure members receive safe, effective, and appropriate care by reviewing services for medical necessity, facilitating discharge planning, and collaborating with providers. Responsibilities include collecting and evaluating clinical information, applying criteria to make coverage determinations, communicating with providers, and identifying opportunities for referrals. Requires active unrestricted RN license, 2+ years acute hospital clinical experience (med-surg, ICU, behavioral health preferred), strong clinical assessment skills, and ability to work independently. Preferred: 1+ year UR or managed care experience. Schedule: Mon-Fri 10am-7pm CST with occasional weekends/holidays. Pay range $26.01-$56.14/hr.