Utilization Care Manager Jobs in Nevada (NOW HIRING)

Job Description:

Please note that a video interview through Microsoft Teams will be required as well as potential onsite interviews and meetings.

Job Specifics

• Application Requirements: Please upload a current resume that includes your work history and relevant licenses or certifications.
• Benefits Eligible: Yes
• FTE:Part time
• Shift:24hrs a week, Wednesday-Friday working on PST time.
• Click learn about additional Intermountain benefits

Essential Functions

• Serves as a liaison between the department and external organizations or individuals, including payers, physicians, post-acute agencies, patients, patient, patient representatives, and other departmental stakeholders.
• Receives and prioritizes requests and transmits clinical information for service authorizations in accordance with contractual requirements and communicates with care managers, utilization review RNs, revenue cycle, and payers as needed to coordinate processes and research payment sources.
• Monitors the status of referrals and maintains ongoing communication.
• Requests and retrieves medical records from Health Information Management for retrospective utilization review or quality assurance.
• Delivers routine regulatory notices to patients within the required timeframes, ensuring proper documentation to support the delivery of government-mandated forms or payer communication.
• Performs clerical tasks to support care management services, including preparing and printing reports, scheduling appointments, distributing and communicating requests, retrieving message (phone, fax, email, and mail), and scanning or copying documents as needed.
• Supports advanced care planning by delivering advance directive information and notarizes documents upon request.
• Supports a compliant patient choice process by ensuring provider lists are current across all systems, distributing them to patients and families as instructed, prior to the patient choice consultation conducted by the care manager or social worker.
• Aids in transition planning by preparing transfer packets, arranging transportation, updating resources on the Integrated Care Management website, and coordinating with patients, families, and next-level providers. Collaborates with care managers to navigate and refer patients to community resources that address social determinants of health.
• Work closely with care managers and clinical teams to ensure patients receive comprehensive and coordinated care. Contribute, in collaboration with Care Management, to the monitoring and success of patient care plans and the resolution of identified social needs.

Minimum Qualifications

• Demonstrated healthcare experience in a clinic or hospital setting.
• Demonstrated customer service with a focus on communications and problem resolution.
• Proficiency in advanced computer skills

• Caregivers whose duties require them to conduct home or community visits must maintain current BLS certification, have a current driver's license, current auto insurance, an acceptable driving record and reliable transportation.

Preferred Qualifications

• Associate or bachelor's degree.
• Previous experience with medical terminology .
• Excellent verbal and written communications skills.

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.
• Mental stamina and flexibility- ability to handle high stress situations, make quick decisions, and manage multiple tasks simultaneously.
• For roles requiring driving: Expected to drive a vehicle which requires sitting, seeing, and reading signs, traffic signals, and other vehicles.

Location:

Work City:

Work State:

Scheduled Weekly Hours:

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

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.

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 usethe artificial intelligence ("AI") platform, HiredScore to improve your job application experience.HiredScore helps match your skills and experiences to the best jobs for you. WhileHiredScore assists in reviewing applications, all final decisions are made byIntermountain 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.