Jobs in the United States

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Added 3 mins ago
Product Manager
Meta
Cheyenne, WY
…federal, state and local law. Meta participates in the E-Verify program in certain locations, as required by law. Please note that Meta may leverage artificial intelligence and machine…
Added 3 mins ago
FINANCE MANAGER
Compass Group, North America
Cheyenne, WY
The Financial Manager is a results-oriented finance focus role reporting to the Sr Director of Finance. This role also works closely with operations leadership and the broader finance team.…
Added 3 mins ago
Global Supply Chain Manager, ODM Network Switches Infrastructure Supply Chain
Meta
Cheyenne, WY
Global Supply Chain Manager, ODM Network Switches Infrastructure Supply Chain Responsibilities:
Added 3 mins ago
Facilities Management Director - Binghamton, NY
Compass Group, North America
Cheyenne, WY
Must have knowledge and expertise in NFPA, TJC, CMS, DNV, EPA, and OSHA codes and regulations and the ability to interpret and implement
Added 3 mins ago
Physician Pay Analyst
Intermountain Health
Cheyenne, WY
The Physician Payroll Analyst collaborates with the Physician Payroll Manager, physicians, and all levels of leaders throughout the organization to administer physician payroll and provide…
Added 16 mins ago
O
Program Manager 3
Oracle
Nashville, TN
- $70,500 to $166,100 USD / year
As a Senior Program Manager, you will oversee the planning, execution, and operational readiness of strategic AI infrastructure and GPU delivery initiatives. You will be responsible for…
Added 17 mins ago
Sr. Retirement Specialist - California
Nationwide Life and Annuity Insurance Co
CA
Life & Health license required · Must have a valid driver’s license with satisfactory driving record in accordance with Nationwide standards
Added 29 mins ago
Manager, Integrated Marketing
PEMCO
Remote, United States
…most trusted insurance company in the Pacific Northwest. The Manager, Integrated Marketing ensures customers experience relevant, timely, and consistent communications throughout their…
Added 32 mins ago
Planning Manager
Senior Operations LLC
Sharon, MA
As the Planning Manager, you will lead our talented planning team and own the master schedule that drives our shop floor and suppliers. Reporting directly to the Director of Supply Chain,…
Added 36 mins ago
S
Administrative Office Coordinator_1876
Sevita
Gilbert, AZ
- $22 to $28 USD / hour
As an Administrative Office Manager, you will Coordinate administrative support for an office or region within a state, which may include coordination of building maintenance, office…
Added 36 mins ago
SOC Manager
Insight Global
Phoenix, AZ
…hunting, threat intelligence, and incident response. The SOC Manager will develop automated response workflows, improve and customize detection capabilities, identify gaps in security…
Added 36 mins ago
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Key Account Director RD
Pfizer
Phoenix, AZ
- $176,600 to $294,300 USD / year
Bachelor's Degree required. MBA or advanced degree in a related field preferred.
Added 44 mins ago
Patient Advocate Specialist
firstsourc
Louisville
For Remote Work from Home - must have a quiet,
Added 46 mins ago
Comm Res Counselor-Fernside
McLean Hospital
Princeton, MA
Under the direction of the Program Manager, the Community Residence Counselor (CRC) provides direct patient care and participates in the therapeutic milieu within the scope of defined…
Added 47 mins ago
Senior Manager, Analyst Relations
Cloudera Government Solution
Boston, MA
As Senior Manager, Analyst Relations, you will help lead and scale a world-class analyst relations program during a pivotal period of company growth. This role will strengthen Cloudera's…
Added 48 mins ago
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District Manager
Driveline
North Haverhill, NH
- $43,888 to $45,000 USD / year
Summary We are seeking a highly motivated, results-driven Retail Operations Manager to lead a team of 100+ hourly merchandising associates, covering 200+ retail locations within a specific…
Added 48 mins ago
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Merchandiser - Meta Representative - FT
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- From $21 USD / hour
…Meta, the representative communicates regularly with ActionLink field leadership and Meta program partners, providing written and verbal updates, detailed installation feedback, and support…
Added 48 mins ago
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District Manager
Driveline
Manchester, NH
- $43,888 to $45,000 USD / year
Summary We are seeking a highly motivated, results-driven Retail Operations Manager to lead a team of 100+ hourly merchandising associates, covering 200+ retail locations within a specific…
Added 48 mins ago
Community Liaison / Clear Lake Area
Harris County
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…various community functions, and conducting outreach in the field by distributing program…
Added 49 mins ago
HR Support Services Coordinator
Hub International Limited
Bothell, WA · San Diego, CA · Bellevue, WA · Sacramento, CA · Newport Beach, CA · Lynnwood, WA · Culver City, CA · San Ramon, CA
Respond to employee and manager inquiries via phone, email, or case management system (e.g., Workday Help or ServiceNow) related to HR policies, procedures, and systems.
Added 56 mins ago
Engineering Project Manager 3
ACS Professional Staffing
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ACS Professional Staffing is looking for an employee to work on-site with our client. This Project Manager 3 role leads and facilitates project management support for large, complex High…
Added 57 mins ago
Manager, Applications Engineering
Syntiant
Redwood City, CA
…solutions space, is looking for an experienced and talented Manager, Applications Engineering to take on a critical role with expansive responsibilities to enhance Applications Engineering…
Added 57 mins ago
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Assessment Support Manager
Butte County
Oroville, CA
- $29.32 to $39.28 USD / hour
…implementing policies and procedures for assigned division, program and project management, and reporting. Incumbents serve as a professional-level resource for research, analyses, and…
Added 57 mins ago
Sr. Manager, Product Line Management
Syntiant
Itasca, IL
Must have 8-12 years of business / engineering related work experience
Added 57 mins ago
Production Manager - Manufacturing
Symmetrio
Littleton, MA
The Production Manager will lead manufacturing operations for complex, low-volume capital equipment, with responsibility for production execution, team leadership, build schedules, quality,…

Closed listing

Intermountain Health

RN Utilization Review Care Manager PRN

Madison, WI, United States

$41.20 - $62.17

This opening has closed.

The original listing is kept below for reference.

Find open jobs More jobs with this employer

About employer

Job details

Pay: $41.20 - $62.17
Posting language: English
Posted: Nov 10, 2026

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Original job description

Archived listing. The details below describe a past opening.

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!

About employer

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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Work requirements

Jobs in the United States