Entry Level Utilization Management Specialist Jobs
New grad utilization management specialist jobs welcome recent graduates and entry level candidates with zero to two years of experience, where a strong internship background or hands-on clinical coursework can matter more than a long resume. Most openings are on-site roles across Healthcare & Medical Services, Insurance, and Technology & Software, with employers like CVS Health, Bryan Health, and CommunityCare hiring at this level now.
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Showing 5 of 7+ Entry Level Utilization Management Specialist jobs
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.
Position Summary
Utilization Management is a 24/7 operation and work schedules will include weekends, holidays, and evening hours.
Location: Central Standard Time Zone Resident
Work Schedule: Mon-Fri 08:00-05:00 PM CST. 12 Weekend shifts per year, occasional weekend shifts (10a-7p) and 2 holidays per year - all subject to change.
- 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.
- Typical office working environment with productivity and quality expectations.
- Work requires the ability to perform close inspection of hand written and computer generated documents as well as a PC monitor.
- Sedentary work involving periods of sitting, talking, listening.
- Work requires sitting for extended periods, talking on the telephone and typing on the computer. Ability to multitask, prioritize and effectively adapt to a fast paced changing environment.
- Position requires proficiency with computer skills which includes navigating multiple systems and keyboarding.
- Effective communication skills, both verbal and written.
Required Qualifications
- 2+ years of experience as a Registered Nurse in adult acute care/critical care setting.
- Must have active current and unrestricted RN licensure in state of residence.
- Utilization Management is a 24/7 operation and work schedules will include weekends, holidays, and evening hours.
(Required) Technical and Logistical Requirements
- Device & System Navigation: Comfortable setting up and using multiple monitors and navigating multiple applications simultaneously to streamline tasks and improve efficiency.
- Communication Tools: Ability to communicate on digital channels such as via email, calendar invites, Teams messaging, and virtual meetings.
- Collaboration & Scheduling: Experience with Microsoft Office 365 (Teams, Outlook, Word, Excel, PowerPoint) applications or similar (Google Workspace).
- Systems Access & Security: Ability to log in to secure systems (e.g., VPN, EHR portal), lock a computer screen when unattended, manage strong passwords, and recognize suspicious emails or links.
- Troubleshooting & Support: Ability to resolve common technical issues independently, such as: restarting an application when frozen, resolving internet connection issues, and contacting IT for unresolved technical issues.
- Future Growth: Openness to learning new skills in the future as the workplace environment evolves.
(Required) Work from Home Requirements
- You must have or be able to obtain a direct/hardwired internet connection to a modem/router within 7 feet of your computer and a minimum download speed of 50 Mbps download and 5 Mbps upload. WiFi and satellite internet are not permitted.
- A quiet, secure and private designated home virtual work location, free from distractions, tidy and organized, compliant with CVS Health and HIPAA guidelines, and allowing for uninterrupted work during work hours.
- Work-from-Home colleagues are required to work within the state and city where they have confirmed they currently live.
- The company will provide equipment (keyboard, monitor, computer, headset, etc.). All new hires should provide their own workspace furniture (desk or standing desk, as this position would require you to be at your desk for extended periods of time).
- If hired, you will commit to obtaining required internet speeds and adhere to all Work From Home requirements.
Preferred Qualifications
- 2+ years of clinical experience required in med surg or specialty area.
- Managed Care experience preferred, especially Utilization Management.
- Preference for those residing in CST zones.
Education
- Associates Degree required.
- BSN preferred.
Anticipated Weekly Hours
40
Time Type
Full time
Pay Range
The typical pay range for this role is:
$32.01 - $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: 11/30/2026
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.
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.
Position Summary
Utilization Management is a 24/7 operation and work schedules will include weekends, holidays, and evening hours.
Location: Central Standard Time Zone Resident
Work Schedule: Mon-Fri 08:00-05:00 PM CST. 12 Weekend shifts per year, occasional weekend shifts (10a-7p) and 2 holidays per year - all subject to change.
- 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.
- Typical office working environment with productivity and quality expectations.
- Work requires the ability to perform close inspection of hand written and computer generated documents as well as a PC monitor.
- Sedentary work involving periods of sitting, talking, listening.
- Work requires sitting for extended periods, talking on the telephone and typing on the computer. Ability to multitask, prioritize and effectively adapt to a fast paced changing environment.
- Position requires proficiency with computer skills which includes navigating multiple systems and keyboarding.
- Effective communication skills, both verbal and written.
Required Qualifications
- 2+ years of experience as a Registered Nurse in adult acute care/critical care setting.
- Must have active current and unrestricted RN licensure in state of residence.
- Utilization Management is a 24/7 operation and work schedules will include weekends, holidays, and evening hours.
(Required) Technical and Logistical Requirements
- Device & System Navigation: Comfortable setting up and using multiple monitors and navigating multiple applications simultaneously to streamline tasks and improve efficiency.
- Communication Tools: Ability to communicate on digital channels such as via email, calendar invites, Teams messaging, and virtual meetings.
- Collaboration & Scheduling: Experience with Microsoft Office 365 (Teams, Outlook, Word, Excel, PowerPoint) applications or similar (Google Workspace).
- Systems Access & Security: Ability to log in to secure systems (e.g., VPN, EHR portal), lock a computer screen when unattended, manage strong passwords, and recognize suspicious emails or links.
- Troubleshooting & Support: Ability to resolve common technical issues independently, such as: restarting an application when frozen, resolving internet connection issues, and contacting IT for unresolved technical issues.
- Future Growth: Openness to learning new skills in the future as the workplace environment evolves.
(Required) Work from Home Requirements
- You must have or be able to obtain a direct/hardwired internet connection to a modem/router within 7 feet of your computer and a minimum download speed of 50 Mbps download and 5 Mbps upload. WiFi and satellite internet are not permitted.
- A quiet, secure and private designated home virtual work location, free from distractions, tidy and organized, compliant with CVS Health and HIPAA guidelines, and allowing for uninterrupted work during work hours.
- Work-from-Home colleagues are required to work within the state and city where they have confirmed they currently live.
- The company will provide equipment (keyboard, monitor, computer, headset, etc.). All new hires should provide their own workspace furniture (desk or standing desk, as this position would require you to be at your desk for extended periods of time).
- If hired, you will commit to obtaining required internet speeds and adhere to all Work From Home requirements.
Preferred Qualifications
- 2+ years of clinical experience required in med surg or specialty area.
- Managed Care experience preferred, especially Utilization Management.
- Preference for those residing in CST zones.
Education
- Associates Degree required.
- BSN preferred.
Anticipated Weekly Hours
40
Time Type
Full time
Pay Range
The typical pay range for this role is:
$32.01 - $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: 11/30/2026
Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.
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Entry Level Utilization Management Specialist Jobs: Frequently Asked Questions
How do I get an entry level utilization management specialist job?
Start by building familiarity with medical necessity criteria, ICD-10 coding basics, and insurance authorization workflows, which are the core skills employers look for at the entry level. A clinical internship, healthcare administration coursework, or even a patient-facing role in a hospital or insurance setting gives you a competitive edge. Certifications like the CMCN or CPUR signal initiative and help your application stand out against other new grad candidates.
Which companies hire entry level utilization management specialists?
Companies hiring entry level utilization management specialists right now include CVS Health, Bryan Health, and CommunityCare, based on current listings on Migrate Mate as of November 2026. At this level, hiring tends to come from health insurance carriers, managed care organizations, and hospital systems that run dedicated utilization review departments and regularly onboard junior staff.
Are there remote entry level utilization management specialist jobs?
Yes, though availability varies by employer and role type. About 50% of entry level utilization management specialist openings are remote or hybrid as of November 2026, making this one of the more accessible healthcare-adjacent roles for candidates who need flexibility. Remote positions typically require reliable internet, a private workspace, and comfort navigating electronic health record systems from day one.
Are these new grad utilization management specialist jobs?
Yes, many of these listings are new grad and junior roles that welcome candidates with little to no prior experience in utilization management. A new grad-friendly posting typically states that it accepts zero to two years of experience, counts internships or clinical rotations toward requirements, or mentions that on-the-job training is provided. Recent graduates with healthcare, nursing, social work, or health administration backgrounds are well-positioned to apply.
Which industries hire the most entry level utilization management specialists?
Entry Level utilization management specialist roles concentrate in Healthcare & Medical Services, Insurance, and Technology & Software, based on current listings on Migrate Mate as of November 2026. These sectors drive entry level hiring because utilization review is a core compliance and cost-management function in managed care and hospital operations, creating consistent demand for junior staff who can be trained on payer-specific guidelines and authorization workflows.