Job Description:

Essential Functions

• Lead Restriction Team 9sometimes referred to as Medicaid Lock-in)
• Lead, supervise, and mentor a team of RN or Behavioral Health Care Managers and RN or Behavioral Health Utilization Review clinicians, and related support positions ensuring clinical excellence and regulatory compliance.
• Oversee daily operations, including staffing, resource allocation, and workflow optimization.
• Manage departmental budgets and performance evaluations, ensuring financial stewardship and achievement of organizational goals.
• Develop, implement, and monitor program structure, processes, and outcome standards for Utilization Review and Care Management.
• Facilitate interdisciplinary collaboration and communication among members, families, providers, and payers.
• Ensure compliance with regulatory bodies (NCQA, CMS, Joint Commission) and patient safety initiatives.
• Champion continuous improvement, address gaps, and monitor internal processes and metrics.
• Coordinate safe transitions of care, including discharge planning and repatriation to participating providers.
• Create and present reports on program performance, including outcome measures and return on investment.
• Support staff development, mentorship, and participation in community outreach activities.

Skills

• Leadership
• Communication
• Utilization review Experience
• Care management Experience
• Team Performance management
• Financial acumen
• Clinical knowledge
• Problem-solving

Minimum Qualifications

• Bachelor’s degree in Nursing (BSN) from an accredited institution or Masters Degree in Clinical Social Work (LCSW)
• Current licensure with compact privileges; must transfer licenses within 60 days.
• Leadership or supervisory experience in clinical or managed care settings.
• Two years of clinical experience and one year in care management or utilization review.
• Strong written and verbal communication skills.
• Intermediate computer skills and ability to troubleshoot independently.
• Completion of required leadership training within one year of accepting the position.

Preferred Qualifications

• Master’s degree in a clinical, education, or business specialty.
• Specialty certification in care management or utilization review.
• Experience in program development and oversight.
• Project management and organizational skills.

Physical Requirements

• Ability to read and assess information, documents, and monitors.
• Frequent verbal communication and hearing for interactions with colleagues and providers.
• Manual dexterity for computer use and equipment handling.
• May be required to sit or stand for extended periods.
• For roles requiring driving: ability to drive and read signs, 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 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.