Remote RN: Utilization Review & Care Management

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

Benefits offered by this job

Generous benefits package

PEAK education program

Fully remote

Job summary

Intermountain Health is seeking an RN Utilization Review Care Management I for a fully remote, part-time role supporting enterprise-wide coverage across Peaks/Canyons/Desert regions. You will review medical records, apply guidelines, and collaborate with providers to authorize appropriate care.

Flexible remote options are offered where approved, with Teams video interviews required. The role requires RN licensure with compact license, BSN within four years, and prior care management or

Qualifications

• RN license in state of practice with compact licensure.
• BSN within four years of hire or promotion.
• Experience in care management/navigation or related field (Utilization Management, discharge planning, managed care).
• Clinical nursing experience in inpatient hospital settings.

Responsibilities

• Review and investigate medical records to ensure appropriate utilization and medical necessity.
• Apply evidence-based guidelines (InterQual/MCG) for prior authorization and post-service reviews.
• Communicate timely and clearly with members, providers, and partners while following regulatory guidelines.
• Engage with providers to ensure safe, efficient care and appropriate care settings.
• Coordinate with internal teams to expedite authorizations and transitions of care.
• Resolve queries about authorizations and medical necessity.
• Mentor UM LPN and non-clinical staff on processes and resources.

Education

RN licensure (state practice) & compact licensure

BSN

Care management/navigation experience

Clinical nursing in hospital setting

Microsoft Office & basic IT skills

Job description

Intermountain Health is seeking an RN Utilization Review Care Management I for a fully remote, part-time role supporting enterprise-wide coverage across Peaks/Canyons/Desert regions. You will review medical records, apply guidelines, and collaborate with providers to authorize appropriate care.

Flexible remote options are offered where approved, with Teams video interviews required. The role requires RN licensure with compact license, BSN within four years, and prior care management or