Manager Utilization Management

Job Description:

Full Time, Monday-Friday 8:00 - 5:30 p.m. Holiday and weekend coverage when needed.

The Manager of Care Management I leads and collaborates with care management operations across utilization review, acute and emergency department care, and ambulatory/community settings, ensuring alignment with broader system-level strategies. This role oversees multiple disciplines at various care sites within a market or region, working collaboratively with medical staff, nursing, clinical, and revenue cycle leaders to optimize patient care and financial performance. Responsible for managing departmental services, including social work and complex care planning, transitions of care, and utilization management. The position ensures compliance with state, national, and regulatory requirements while fostering workforce development. The manager plays a crucial role in shaping enterprise-wide strategies to deliver safe, high-quality, patient-centered, and equitable care. Additionally, this role may require travel to various locations for operational oversight and leadership support.

Scope: This position manages a department with operations primarily Monday through Friday (may include weekend support for escalations) in non-24-hour service areas, regardless of the size of the facility, or has a small number of direct reports in 24-hour departments of medium or large facilities due to specific reporting structure considerations. Oversee operations of staffing, escalations, barrier triage, and coordination with compliance and legal to support care delivery.

The Manager Care Management I reports to the Care Management Director.

Position Details

• Full Time Monday - Friday, 8:00 - 5:30
• Occasional weekend or holiday coverage
• Possibility of remote work some days
• Main Location - Nevada Central Office in Las Vegas, must be local.
• 7 days a week, holidays/weekends remote

Essential Functions

• Patient Experience & Advocacy: Drives patient satisfaction programs and mentors staff in service excellence.
• System-Wide Collaboration: Represents care management with healthcare executives, post-acute providers, multidisciplinary teams, and outreach programs to improve care transitions and service integration.
• Process Improvement Leadership: Drives high-impact change initiatives, monitors key performance indicators, and leads quality assurance efforts.
• Change Management: Leads strategic initiatives to support enterprise KPI’s and outcomes, manages transitions, and involves staff in decision-making.
• Continuous Improvement: Implements best practices, drives quality enhancements, and optimizes operational effectiveness.

Skills

• Care Management
• Leadership
• Accountability
• People Management
• Financial Acumen
• Data Analysis & Reporting
• Coaching & Mentoring
• Strategic Planning
• Continuous Improvement
• Scheduling

Minimum Qualifications

• Current Registered Nurse (RN) license in state of practice OR Licensed Clinical Social Worker (LCSW)/Licensed Master of Social Work (LMSW) or applicable license in state of practice with relevant experience at this licensure.
• Bachelor of Science in Nursing (BSN) OR Master of Social Work (MSW) from an accredited institution (degree verification required).
• Care Management Certification within 24 months of hire or promotion.
• Demonstrated care management experience.
• Authorization or Utilization Management experience.
• Leadership experience.

Preferred Qualifications

• Previous management experience in hospital care management, utilization review, ambulatory care management, ambulatory utilization review, or related area.

Physical Requirements

• Ongoing need to see and read information, labels, assess patient needs, operate monitors, identify equipment and supplies.
• Frequent interactions with patient care providers, patients, and visitors that require employee to verbally communicate as well as hear and understand spoken information, alarms, needs, and issues quickly and accurately, particularly during emergency situations.
• Manual dexterity of hands and fingers to manipulate complex and delicate equipment with precision and accuracy. This includes frequent computer use and typing for documenting patient care, accessing needed information, medication preparation, etc.
• Expected to lift and utilize full range of movement to transfer patients. Will also bend to retrieve, lift, and carry supplies and equipment. Typically includes items of varying weights, up to and including heavy items.
• Need to walk and assist with transporting/ambulating patients and obtaining and distributing supplies and equipment. This includes pushing/pulling gurneys and portable equipment, including heavy items. Often required to navigate crowded and busy rooms (full of equipment, power cords on the floor, etc.)
• May be expected to stand in a stationary position for an extended period of time.
• For roles requiring driving: Expected to drive a vehicle which requires sitting, seeing and reading signs, traffic signals, and other vehicles.

Location:

Nevada Central Office

Work City:

Las Vegas

Work State:

Nevada

Scheduled Weekly Hours:

40

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

$44.33 - $68.42

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.

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.

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