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VH
Advanced Medical Laboratory Technician
Veterans Health Administration
Nashville, TN
- $59,568 to $77,440 USD / year
Carries out day-to-day operations related to laboratory information systems/computer use and system maintenance.
Added just now
VH
Registered Nurse - Spinal Cord Injury
Veterans Health Administration
Long Beach, CA
- $114,291 to $195,498 USD / year
…performance include knowledge and active participation in unit/program level quality improvement processes and initiatives as well as customer service…
Added just now
TS
Supervisory Transportation Security Officer
Transportation Security Administration
Montrose, CO
- $74,678 to $97,087 USD / year
Overseeing screening checkpoint(s) and/or baggage screening operations on a day-to-day basis to include equipment, personnel, and the scheduling and rotation of personnel.
Added just now
UA
Supervisory Supply Management Specialist
U.S. Army Corps of Engineers
Rufus, OR
- $74,678 to $97,087 USD / year
…which includes 1) Serving as an accountable officer, property manager, or lead technician utilizing automated inventory/warehouse systems to maintain stock controls, reconcile inventory…
Added just now
BO
Program Manager (Deputy Area Manager)
Bureau of Reclamation
Carson City, NV
- $146,848 to $181,254 USD / year
You will serve as a Program Manager (Deputy Area Manager) with the Bureau of Reclamation, Lahontan Basin Area Office, assisting the Area Manager in the day-to-day management of program…
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VH
Registered Nurse (RN) - Float Pool / RECRUITMENT INCENTIVE
Veterans Health Administration
Tomah, WI
- $83,547 to $154,702 USD / year
…by one of the following accrediting bodies at the time the program was completed by the applicant: The Accreditation Commission for Education in Nursing (ACEN) or The Commission on…
Added just now
VH
Registered Nurse - Referral Coordination Team
Veterans Health Administration
Des Moines, IA
- $75,278 to $139,394 USD / year
…by one of the following accrediting bodies at the time the program was completed by the applicant: The Accreditation Commission for Education in Nursing (ACEN) or The Commission on…
Added just now
VH
Licensed Professional Mental Health Counselor - Program Coordinator - ACMHMP
Veterans Health Administration
Salt Lake City, UT
- $106,437 to $138,370 USD / year
…(IPU), Substance Abuse Residential Rehabilitation Treatment Program (SARRTP), Services for Outpatient Addiction Recovery (SOAR), Medical Psychiatry Services, Access Crisis Team (ACT), and…
Added just now
VH
Registered Nurse (RN) - Acute Care (AC) / RECRUITMENT INCENTIVE
Veterans Health Administration
Tomah, WI
- $81,475 to $154,702 USD / year
…by one of the following accrediting bodies at the time the program was completed by the applicant: The Accreditation Commission for Education in Nursing (ACEN) or The Commission on…
Added 2 mins ago
OA
Deputy Program Manager
Other Agencies and Independent Organizations
Remote, United States
- $125,776 to $197,200 USD / year
Serves as the second-in-command to the MAST Program Manager, assisting in the management of program activities and providing day-to-day direction to program and contract staff in the…
Added 2 mins ago
TS
Supervisory Program Manager
Transportation Security Administration
Atlantic City, NJ
- $163,023 to $205,353 USD / year
The Supervisory Program Manager (Assistant Supervisory Air Marshal in Charge (ASAC)) for the TSA Training Center (TCACY) provides effective learning environments and opportunities using…
Added 2 mins ago
VH
Registered Nurse - Outpatient Mental Health
Veterans Health Administration
Idaho Falls, ID
- $72,581 to $130,670 USD / year
This position is eligible for the Education Debt Reduction Program (EDRP), a student loan payment reimbursement program. You must meet specific eligibility requirements per VHA policy &…
Added 2 mins ago
DL
Cook (CYS) NA-08
Defense Logistics Agency
Columbus, OH
- $23 to $27 USD / hour
Applies knowledge and skill to assist in planning and implementing a comprehensive food service program that follows the policies and procedures of the USDA Child and Adult Care Food…
Added 2 mins ago
VH
Social Worker (Patient Align Care Team-Inpatient)
Veterans Health Administration
Corpus Christi, TX
- $64,883 to $101,981 USD / year
Use the social work process to conduct case management screenings for Post 9/11 M2VA Case Management Program veterans; utilizes clinical reminders to evaluate the need for health care,…
Added 2 mins ago
VH
Clinical Laboratory Scientist (Ancillary Testing Coordinator)
Veterans Health Administration
Johnson City, TN
- $89,508 to $116,362 USD / year
This position is eligible for the Education Debt Reduction Program (EDRP), a student loan payment reimbursement program. You must meet specific eligibility requirements per VHA policy and…
Added 2 mins ago
VH
Senior Social Worker (PACT)
Veterans Health Administration
Harlingen, TX
- $93,537 to $121,601 USD / year
…national use. The Senior Social Worker utilizes data regarding day-to-day functioning and program evaluation. The incumbent ensures the GeriPACT program is in compliance with VHA directives…
Added 2 mins ago
VH
Physician- Associate Chief of Mental Health- Inpatient Care
Veterans Health Administration
Salt Lake City, UT
- $200,000 to $335,000 USD / year
Paid Time Off: 50-55 days of paid time off per year (26 days of annual leave, 13 days of sick leave, 11 paid Federal holidays per year and possible 5 day paid absence for CME)
Added 2 mins ago
VH
Psychiatric Mental Health Nurse Practitioner - Inpatient Psychiatric Unit Supervisor
Veterans Health Administration
Salt Lake City, UT
- $129,567 to $187,824 USD / year
Duties and responsibilities involve broad program management and direct supervision of staff.
Added 2 mins ago
AN
TITLE 5 PSYCHOLOGICAL HEALTH PROGRAM MANAGER (MI OSS)
Army National Guard Units
Lansing, MI
- $98,729 to $128,350 USD / year
This National Guard position is for a TITLE 5 PSYCHOLOGICAL HEALTH PROGRAM MANAGER (MI OSS), Position Description Number NGT5854000 and is part of the MI JFHQ Army, National Guard.Duties
Added 2 mins ago
VH
Advanced Practice Nurse - Certified Nurse Practitioner - Hematology & Oncology
Veterans Health Administration
Youngstown, OH
- $95,487 to $172,334 USD / year
…by one of the following accrediting bodies at the time the program was completed by the…
Added 2 mins ago
VH
Physician- Inpatient Psychiatric Unit Program Manager
Veterans Health Administration
Salt Lake City, UT
- $235,000 to $335,000 USD / year
The incumbent is responsible to serve as the Medical Director, Supervisor of non-nursing staff, and Program Manager of the IPU. Additionally, the incumbent will provide direct patient care…
Added 4 mins ago
VH
Registered Nurse - Ambulatory Care Nurse Manager (PACU)
Veterans Health Administration
Little Rock, AR
- $85,939 to $176,681 USD / year
Ambulatory Care PACU Nurse Manager functions as a clinical expert and is responsible and accountable for all elements of the nursing process when providing or supervising direct patient…
Added 4 mins ago
VH
Registered Nurse (Assistant Nurse Manager)
Veterans Health Administration
Salt Lake City, UT
- $88,970 to $148,317 USD / year
The Assistant Nurse Manager (ANM) for the Substance Abuse Residential Rehabilitation Treatment Program (SARRTP) supports the Nurse Manager (NM) in overseeing operations of a nursing…
Added 4 mins ago
AF
Logistics Management Specialist
Air Force Materiel Command
Langley AFB, VA
- $108,019 to $140,426 USD / year
…technical guidance as the senior headquarters-level logistics program manager and technical expert. Serves as the MAJCOM senior Logistics action officer, applying Air Force military…
Added 4 mins ago
VH
Registered Nurse - Assistant Nurse Manager
Veterans Health Administration
Fredericksburg, VA
- $100,406 to $167,406 USD / year
Assistant Nurse Manager (ANM) supports the Nurse Manager (NM) with supervisory duties and responsibility and accountability for the 24/7 operation of their designated units.

Intermountain Health

RN Utilization Review Care Manager PRN

Albany, NY, United States

$41.20 - $62.17

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Job details

Pay: $41.20 - $62.17
Posting language: English
Posted: Nov 9, 2026

Original job description

Fully Remote

St. Marys Regional Hospital

Part time

R189124

Job Description:

The RN Utilization Review Care Management I leverages clinical expertise and critical thinking to perform utilization review care management screenings, assessments, and evaluations, with a strong focus on resource stewardship. This role involves developing and implementing plans that promote cost-effective, high-quality care. Collaboration with patients, their families or significant others, healthcare providers, insurers, and other involved parties is essential to ensure compliant, efficient, effective, and patient-centered utilization review services.

We are committed to offering flexible work options where approved and stated in the job posting. However, we are currently not considering candidates who reside or plan to reside in the following states:

California, Connecticut, Hawaii, Illinois, Massachusetts, Maine, Minnesota, New York, Pennsylvania, Rhode Island, Virginia Vermont, Washington.

Please note that a video interview through Microsoft Teams will be required.

Position Details:

Shift coverage enterprise wide - Peaks/Canyons/Desert regions
Average 2 days per week; 2 weekends per 8-week schedule
Holiday coverage is also required
RN Licensure with compact required
8:00 AM - 5:00 PM

Essential Functions

Reviews and investigates medical records and applies clinical expertise to assure appropriate benefit utilization and medical necessity as relates to requested services, authorization history, and treatment plan.
Uses in-depth knowledge of medical procedures, treatments, and diagnosis to apply evidence-based guidelines (e.g. InterQual/MCG) and medical policies for prior authorization and post service reviews.
Follows the applicable regulatory guidelines (NCQA, CMS, State, plan) and ensures timely review with clear and accurate communication to members and requesting providers. Adheres to regulatory guidelines and timely communication with members, providers, and internal/external partners.
Based on medical necessity and clinical best practice, proactively engages with providers to ensure safe and efficient medical care, appropriate care setting, and safe transitions of care referring to alternate programs as applicable.
Collaborates with physicians, internal staff, members, and families to assist in expediting the requested authorizations, and directs toward medically necessary care and the correct level/setting for services requested.
Engage proactively with members and providers for safe, efficient care and transitions as applicable to continuity of care, redirection, and authorization determination.
Resolves queries regarding authorizations, treatment plans, and medical necessity determinations.
Mentors and guides the UM LPN & non-clinical on process/clinical questions and application of resources.

Skills

Utilization Management
Clinical Expertise
Investigative Acumen
Medical Diagnosis & Treatment
Medical Terminology
Time Management
Problem Solving
Quality Care
Communication

Minimum Qualifications

Current Registered Nurse (RN) license in state of practice, and compact licensure within service area.
Bachelor of Science in Nursing (BSN) from an accredited institution (degree verification required). RNs hired or promoted into this role must obtain their BSN within four (4) years of hire or promotion date.
Demonstrated experience in care management/navigation or closely related field including: Utilization Management, discharge planning, managed care, health promotion, health coaching, behavioral health, or Patient Educator job role.
Demonstrated clinical nursing experience in an inpatient hospital setting, and familiarity with hospital patient-related terminology and processes.
Demonstrated understand of disease management including treatment, length of stay, identifying barriers to delivery of care and any variation.
Strong written, verbal communication and conflict resolution skills
Basic computer hardware set-up, ability to customize computer settings and use multiple monitors and capable of independent troubleshooting internet and applications. Knowledge of Microsoft Office software.
Ability to work independently, be self-motivated, have a positive attitude, and be flexible in a rapidly changing environment.
Strong written, verbal communication and conflict resolution skills

Preferred Qualifications

One (1) year experience in care management/navigation or closely related field including: Utilization Management, discharge planning, managed care, health promotion, health coaching, behavioral health, or Patient Educator job role.
Three (3) years of experience and expertise working in clinical nursing in an ambulatory care setting, community health or home care.
Bachelor’s degree in nursing (BSN) from an accredited institution (degree will be verified).
Case management or utilization, or health care quality certification
Previous experience working with third party payers.
Ability to work independently and be flexible in a rapidly changing environment.
Experience working successfully working in a remote environment or using Advanced Microsoft Suite, including Teams (chat, whiteboard, task tracking) & Outlook.

Physical Requirements

Ongoing need for employee to see and read information, labels, documents, monitors, identify equipment and supplies, and be able to assess customer needs.
Frequent interactions with providers, colleagues, customers, patients/clients and visitors that require employee to verbally communicate as well as hear and understand spoken information, needs, and issues quickly and accurately.
Manual dexterity of hands and fingers to manipulate complex and delicate supplies and equipment with precision and accuracy. This includes frequent computer use for typing, accessing needed information, etc.
For roles requiring driving: Expected to drive a vehicle which requires sitting, seeing and reading signs, traffic signals, and other vehicles.

Location:

St. Marys Regional Hospital

Work City:

Grand Junction

Work State:

Colorado

Scheduled Weekly Hours:

The hourly range for this position is listed below. Actual hourly rate dependent upon experience.

$41.20 - $62.17

We care about your well-being – mind, body, and spirit – which is why we provide our caregivers a generous benefits package that covers a wide range of programs to foster a sustainable culture of wellness that encompasses living healthy, happy, secure, connected, and engaged.

Learn more about our comprehensive benefits package here (https://intermountainhealthcare.org/careers/benefits) .

By applying for a position with Intermountain, I acknowledge that I will comply with all applicable Intermountain policies and expectations. If applying for a remote or hybrid role, this includes remote work expectations related to confidentiality, information security, work schedules, conflicts of interest, and use of company equipment. I further acknowledge that outside employment or activities may not interfere with job responsibilities or create a conflict of interest with Intermountain. Actual or reasonably perceived conflicts may be grounds for disqualification from consideration or, if hired, corrective action up to and including termination of employment.

Intermountain Health is an equal opportunity employer. Qualified applicants will receive consideration for employment without regard to race, color, religion, age, sex, sexual orientation, gender identity, national origin, disability or protected veteran status.

At Intermountain Health, we use the artificial intelligence ("AI") platform, HiredScore to improve your job application experience. HiredScore helps match your skills and experiences to the best jobs for you. While HiredScore assists in reviewing applications, all final decisions are made by Intermountain personnel to ensure fairness. We protect your privacy and follow strict data protection rules. Your information is safe and used only for recruitment. Thank you for considering a career with us and experiencing our AI-enhanced recruitment process.

All positions subject to close without notice.

Headquartered in Utah with locations in six primary states and additional operations across the western U.S., Intermountain Health is a nonprofit system of 34 hospitals, 400+ clinics, a medical group of more than 4,800 employed physicians and advanced care providers, a health plan division called Select Health with more than one million members, and other health services. Helping people live the healthiest lives possible, Intermountain is widely recognized as a leader in clinical quality improvement and efficient healthcare delivery.

Join our world-class team and embark on a career filled with opportunities, strength, innovation, and fulfillment.

To find out more about us, head to our career site here (https://intermountainhealthcare.org/careers/?utm_source=Workday&utm_medium=Redirect&utm_campaign=CareerHome_workday) .

Sign up for job alerts! Click ‘sign in’ at the top right corner, create a candidate account, and when we have opportunities that meet your interests, you will receive an email with the job details.

Intermountain Health strives to make the application process accessible to all users. If you would like to contact us regarding the accessibility of our website or need assistance completing the application process, please contact 1-800-843-7820 or email recruitment@imail.org . This contact information is for accommodation requests only and cannot be used to inquire about the status of applications.

Introduce yourself to our Talent Acquisition team and we will get in touch if there is a role that seems like a good match.

Intermountain Health’s PEAK program supports caregivers in the pursuit of their education goals and career aspirations by providing up-front tuition coverage paid directly to the academic institution. The program offers 100+ learning options to choose from, including undergraduate studies, high school diplomas, and professional skills and certificates. Caregivers are eligible to participate in PEAK on day 1 of employment. Learn more. (https://intermountainhealthcare.org/careers/working-for-intermountain/employee-benefits/peak-program/)

The primary intent of this job description is to set a fair and equitable rate of pay for this classification. Only those key duties necessary for proper job evaluation and/or labor market analysis have been included. Other duties may be assigned by the supervisor.

All positions subject to close without notice.

Thanks for your interest in continuing your career with our team!

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More about this job

Skills

Critical thinking
Collaboration
Microsoft Teams
CMS
Communication skills
LPN
Medical terminology
Time management
Problem solving
RN
Coaching
Conflict resolution
Troubleshooting
Microsoft Office
Work independently
Community medicine
Case management
Microsoft Outlook
Drive vehicles
Market analysis

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