Remote RN: Utilization Review & Care Management

Intermountain Healthcare Inc.; Atlanta (GA); Remote; USD 57,000 - 86,000; Part time

Benefits offered by this job

Benefits package

Job summary

Intermountain Health is seeking an RN Utilization Review Care Management I for remote, part-time coverage across enterprise regions. The role focuses on utilization review, evaluating care plans, and ensuring compliant, efficient, and patient-centered services with collaboration among patients, families, providers, and insurers.

The position emphasizes strong clinical judgment, knowledge of guidelines (InterQual/MCG), and regulatory compliance, with scheduled hours 8:00 AM to 5:00 PM and a

Qualifications

• Current RN license in state of practice with compact licensure within service area.
• BSN from an accredited institution; must obtain BSN within four years of hire/promotion.

Responsibilities

• Reviews and investigates medical records to assure appropriate benefit utilization and medical necessity for services.
• Applies evidence-based guidelines and policies for prior authorization and post-service reviews.
• Ensures timely reviews and clear communication with members, providers, and partners.

Skills

Utilization Management

Clinical Expertise

Investigative Acumen

Medical Terminology

Time Management

Problem Solving

Quality Care

Communication

Education

BSN (Bachelor of Science in Nursing)

RN license with compact licensure

Tools

Microsoft Office

Microsoft Teams

Outlook

Job description

Intermountain Health is seeking an RN Utilization Review Care Management I for remote, part-time coverage across enterprise regions. The role focuses on utilization review, evaluating care plans, and ensuring compliant, efficient, and patient-centered services with collaboration among patients, families, providers, and insurers.

The position emphasizes strong clinical judgment, knowledge of guidelines (InterQual/MCG), and regulatory compliance, with scheduled hours 8:00 AM to 5:00 PM and a