OPT Utilization Management Nurse Jobs
Utilization Management Nurse jobs are a strong fit for F-1 OPT students with a nursing or healthcare management background. These roles are typically office-based or remote, which matters for OPT because your employer must be a single, verifiable organization. STEM OPT extension is not available for standard RN-track roles unless your degree falls under a STEM-designated CIP code.
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Get Access To All JobsINTRODUCTION
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.
Utilization Management is a 24/7 operation and work schedule may include weekends, holidays, and evening hours.
SCHEDULE
Fully Remote - WFH
M-F 8A-5P EST/9A-6P CST with 1 hour lunch
Position Summary
UM Nurse Consultant
Utilizes clinical experience and skills in a collaborative process to assess, plan, implement, coordinate, monitor and evaluate options to facilitate appropriate healthcare services/benefits for members.
Gathers clinical information and applies the appropriate clinical criteria/guideline, policy, procedure and clinical judgment to render coverage determination/recommendation along the continuum of care. Communicates with providers and other parties to facilitate care/treatment. Identifies members for referral opportunities to integrate with other products, services and/or programs. Identifies opportunities to promote quality effectiveness of Healthcare Services and benefit utilization. Consults and lends expertise to other internal and external constituents in the coordination and administration of the utilization/benefit management function.
REQUIRED QUALIFICATIONS
- 3+ years of experience as an RN
- Active and unrestricted RN licensure in state of residence
- Able to work in multiple IT platforms/systems
- 1+ years of experience with Microsoft Office Applications (Outlook, Teams, Excel)
PREFERRED QUALIFICATIONS
- Prior authorization utilization experience preferred
- Outpatient Clinical experience
- Knowledge of Medicare/Medicaid
- Managed care experience
Education
Associates Degree in Nursing required
BSN preferred
ANTICIPATED WEEKLY HOURS
40
TIME TYPE
Full time
PAY RANGE
The typical pay range for this role is:
$26.01 - $68.55
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: 08/12/2026
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.
INTRODUCTION
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.
Utilization Management is a 24/7 operation and work schedule may include weekends, holidays, and evening hours.
SCHEDULE
Fully Remote - WFH
M-F 8A-5P EST/9A-6P CST with 1 hour lunch
Position Summary
UM Nurse Consultant
Utilizes clinical experience and skills in a collaborative process to assess, plan, implement, coordinate, monitor and evaluate options to facilitate appropriate healthcare services/benefits for members.
Gathers clinical information and applies the appropriate clinical criteria/guideline, policy, procedure and clinical judgment to render coverage determination/recommendation along the continuum of care. Communicates with providers and other parties to facilitate care/treatment. Identifies members for referral opportunities to integrate with other products, services and/or programs. Identifies opportunities to promote quality effectiveness of Healthcare Services and benefit utilization. Consults and lends expertise to other internal and external constituents in the coordination and administration of the utilization/benefit management function.
REQUIRED QUALIFICATIONS
- 3+ years of experience as an RN
- Active and unrestricted RN licensure in state of residence
- Able to work in multiple IT platforms/systems
- 1+ years of experience with Microsoft Office Applications (Outlook, Teams, Excel)
PREFERRED QUALIFICATIONS
- Prior authorization utilization experience preferred
- Outpatient Clinical experience
- Knowledge of Medicare/Medicaid
- Managed care experience
Education
Associates Degree in Nursing required
BSN preferred
ANTICIPATED WEEKLY HOURS
40
TIME TYPE
Full time
PAY RANGE
The typical pay range for this role is:
$26.01 - $68.55
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: 08/12/2026
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.
See all 103+ OPT Utilization Management Nurse Jobs
Sign up for free to unlock all listings, filter by visa type, and get alerts for new OPT Utilization Management Nurse Jobs.
Get Access To All JobsTips for Finding OPT Sponsorship as an Utilization Management Nurse
Confirm your employer is OPT-eligible
UM Nurse roles are often filled through staffing agencies or managed care organizations. Make sure your direct employer, the entity signing your offer letter, is a legitimate business with an EIN and can verify your employment for SEVP reporting purposes.
Check your active OPT dates before applying
Your OPT period is tied to your EAD card dates. UM roles take weeks to hire, so apply early enough that your EAD will remain valid through onboarding. Starting a job even one day before or after your EAD dates is a status violation.
Clarify remote work arrangements with your DSO
Many UM Nurse positions are fully remote. SEVP requires a reportable employer address on your SEVIS record. Confirm with your DSO how to properly report a remote role so your record stays compliant throughout your OPT period.
Highlight clinical utilization skills in your resume
UM roles prioritize InterQual or Milliman criteria knowledge, payer authorization experience, and case review. Candidates who surface these skills clearly in their resume move faster through screening, which matters when you have a fixed OPT window.
Target managed care organizations and large health systems
National insurers and large health systems hire UM nurses at scale and typically have established HR processes for work authorization. Smaller clinical practices often lack the infrastructure to onboard international employees compliantly. Focus your search accordingly.
Use Migrate Mate to find OPT-friendly UM Nurse openings
Not all job boards filter for OPT compatibility. Migrate Mate surfaces roles from employers with a track record of sponsoring or hiring international candidates, saving you time and reducing the risk of pursuing roles that will stall at authorization.
Utilization Management Nurse OPT: Frequently Asked Questions
Can I work as a Utilization Management Nurse on F-1 OPT?
Yes, if your OPT is authorized for healthcare or nursing and your degree is in a qualifying field. Utilization Management is considered practice related to nursing, so it generally satisfies the OPT requirement that your job be directly related to your major. Confirm the connection with your DSO before accepting an offer if your degree is in a non-clinical health field.
Do Utilization Management Nurse jobs qualify for the STEM OPT extension?
Only if your nursing or health informatics degree was awarded under a STEM-designated CIP code. Most traditional BSN and MSN programs are not STEM-designated, which means you would have 12 months of OPT rather than 36. If you have a degree in health informatics, biomedical engineering, or a related STEM field and are applying to a UM role, verify your CIP code with your DSO.
Will employers sponsor H-1B for Utilization Management Nurse roles?
Some do, particularly large managed care organizations and national insurers that hire UM nurses at volume. H-1B visa eligibility depends on the role being classified as a specialty occupation requiring at least a bachelor's degree in a specific field. UM Nurse positions typically meet that standard given the clinical review and case management complexity involved. Browse Migrate Mate to identify employers with a history of sponsoring these roles.
How should I report a fully remote Utilization Management Nurse job during OPT?
Remote work on OPT requires a valid, reportable employer address in your SEVIS record. You cannot list your home address as your employer's address. Your employer must have a principal place of business that your DSO can enter in SEVIS. Notify your DSO as soon as you receive an offer and before your start date so your record is updated correctly.
What licensing requirements should I be aware of when job searching on OPT?
Most UM Nurse positions require an active, unrestricted RN license in at least one U.S. state, and some employers require licensure in the states where the patients are located. Compact license states simplify multi-state coverage. Verify your license is active and in good standing before applying, and factor in any renewal timelines relative to your OPT expiration date.