Description
CVS Health / American Health Holding, Inc. is hiring a fully remote Utilization Management Nurse Consultant specializing in Medical Review to evaluate medical necessity, apply clinical criteria and plan language, and collaborate with providers and medical directors. The role requires an active RN license, at least 3 years of clinical experience, 1+ year in utilization review or medical management, strong independent clinical judgment, and comfort working in a desk-based, metric-driven environment. The position is full-time, Monday through Friday, 8:00am–5:00pm EST, with a mandatory 3-week training period, and offers hourly pay plus a comprehensive benefits package including medical, dental, and vision coverage.
