Description

We're building a world of health around every individual - shaping a more connected, convenient and compassionate health experience. At CVS Health®, you'll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger - helping to simplify health care one person, one family and one community at a time.

Remote Utilization Management RN (Prior Authorization)

Full-Time | Remote | Weekend Schedule

We're seeking an experienced Registered Nurse (RN) to join our Utilization Management team in a fully remote role. This position is ideal for nurses who enjoy applying clinical judgment, working collaboratively with providers, and influencing quality healthcare decisions-without bedside demands.

Schedule:

• Saturday & Sunday (CST) with flexible consecutive weekdays to meet business needs
• 10-hour shifts after training
• Must be available Monday-Friday during business hours for training
• UM operates 24/7, with potential evenings, holidays, or on-call coverage

What You'll Do

• Review clinical documentation and apply evidence-based criteria to authorize services or escalate cases to a Medical Director
• Communicate with providers to gather information and facilitate timely care
• Support appropriate utilization of healthcare benefits across the continuum of care
• Identify opportunities for referrals, care coordination, and quality improvement
• Collaborate with internal and external partners in utilization and benefit management

What We're Looking For

Required:

• Active, unrestricted Compact RN license in the state of residence, OR Texas RN license
• 3+ years of clinical nursing experience
• Proficiency with Microsoft Office and navigating multiple systems
• Strong critical thinking, communication, and multitasking skills
• Comfort working in a fast-paced, remote, desk-based environment

Preferred:

• Prior Authorization or Utilization Management experience
• BSN preferred

Education

• Associate's degree in nursing required
• BSN preferred

If you're a detail-oriented RN who thrives in a structured, virtual environment and wants to make an impact on care quality and access, we'd love to hear from you.

Anticipated Weekly Hours
40

Time Type
Full time

Pay Range

The typical pay range for this role is:

$26.01 - $56.14

This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above.

Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.

Great benefits for great people

We take pride in offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families.

This full‑time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial well‑being of colleagues and their families. The benefits for this position include medical, dental, and vision coverage, paid time off, retirement savings options, wellness programs, and other resources, based on eligibility.

Additional details about available benefits are provided during the application process and on Benefits Moments.

We anticipate the application window for this opening will close on: 05/09/2026

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.