# Utilization Management Nurse Consultant Clinical Precertification RN

**Company**: CVS Health
**Work arrangement**: remote
**Job type**: full-time
**Salary**: $26.01 - $56.14
**Category**: Healthcare
**Industry**: Healthcare

**Apply**: https://cvshealth.wd1.myworkdayjobs.com/en-US/CVS_Health_Careers/job/GA---Work-from-home/Utilization-Management-Nurse-Consultant--Work-From-Home-_R1095916?utm_source=yubhub.co&utm_medium=jobs_feed&utm_campaign=apply
**Canonical**: https://yubhub.co/job/utilization-management-nurse-consultant-clinical-d3be05f2-9f5/

## Description

We're building a world of health around every individual , shaping a more connected, convenient and compassionate health experience.

As a Utilization Management Nurse Consultant Clinical Precertification RN, you will use your clinical expertise to ensure members receive the right care at the right time.

**Responsibilities**

- Review clinical cases and make coverage determinations using evidence-based guidelines

- Collaborate with providers, attending MDs and care teams to complete precertification requests

- Apply clinical judgment to support utilization and benefit management decisions

- Identify opportunities to improve care quality and member outcomes

- Serve as a clinical resource across internal and external stakeholders

**Requirements**

- Active, unrestricted RN license in the state of residence

- 2+ years of RN experience, including 1+ year in Med/Surg

- Strong clinical assessment and decision-making skills

- Experience with Microsoft Office (Outlook, Teams, Excel)

- Ability to work Monday–Friday, 9:00 AM–6:00 PM in your time zone

- Associate Degree in Nursing

**Preferred Qualifications**

- Utilization Management or Prior Authorization experience

- Managed care background

- Ambulatory surgery background

- BSN preferred

**Benefits**

- Medical, dental, and vision coverage

- Paid time off

- Retirement savings options

- Wellness programs

- Other resources, based on eligibility

For more fresh new jobs, check out [yubhub.co](https://yubhub.co/).

## Skills

### Required
- RN license
- Microsoft Office
- clinical assessment
- decision-making

### Nice to have
- Utilization Management
- Prior Authorization
- Managed care
- Ambulatory surgery
- BSN

---

Source: [Apply at cvshealth.wd1.myworkdayjobs.com](https://cvshealth.wd1.myworkdayjobs.com/en-US/CVS_Health_Careers/job/GA---Work-from-home/Utilization-Management-Nurse-Consultant--Work-From-Home-_R1095916?utm_source=yubhub.co&utm_medium=jobs_feed&utm_campaign=apply)