IntusCare
Utilization Management Nurse
Remote-USA · Director
No sponsorship$80k-$95kDetected 65 days ago
LeadershipCommunicationCollaborationProblem SolvingCritical Thinking
About the role
- The Utilization Management Nurse plays a critical role in ensuring high-quality, cost-effective, and compliant care for PACE participants supported by IntusCare.
- Blending clinical expertise with analytical thinking, the Utilization Management Nurse ensures services are medically necessary, aligned with care plans and consistent with PACE regulations and best practices.
- This role is essential to maintaining program integrity, improving participant outcomes and supporting the delivery of coordinated, value-based care.
Responsibilities
- IntusCare is the only end-to-end ecosystem built specifically to help Programs of All-Inclusive Care for the Elderly (PACE) programs deliver exceptional care, strengthen financial performance, and stay compliant.
Requirements
- Ability to use data to drive decisions and collaboration with internal and external stakeholders.
- Excellent communication and leadership abilities, capable of motivating and guiding teams toward timely and efficient care management strategies
- What We Offer
- A chance to be a part of a trailblazing team in healthcare technology.
- Opportunities for professional growth and development
- Compensation: The salary range for this role is $80K-$95K. We expect the ideal candidate to fall near the midpoint of this range, though final compensation will be determined based on experience, skills, and organizational needs.
Skills
- Advocate quality care and enhanced quality of life
- Advocate decreased hospital stay when appropriate
- Maintain accurate records of all patient related interactions
- Appeal Management
- Comprehensive review of provider network appeals.
- 3 to 5 years of utilization management experience.
- Current RN license
- Proven experience working in risk based integrated models of care.
- Strong strategic thinking, problem solving, and decision making skills.
- Competitive salary and equity package.
- Comprehensive benefits including health, dental, and vision insurance.
- A collaborative, inclusive, and dynamic work environment.
Compensation
- The salary range for this role is $80K-$95K.
- We expect the ideal candidate to fall near the midpoint of this range, though final compensation will be determined based on experience, skills, and organizational needs.
- Compensation: The salary range for this role is $80K-$95K.
Benefits
- IntusCare replaces outdated technology and manual workarounds with purpose-built solutions for care coordination, risk adjustment, population health, and utilization management.
- IntusCare empowers teams to take control of their operations and improve outcomes for dual-eligible seniors - some of the most socially vulnerable and clinically complex individuals in the US healthcare system.
- In accordance with accepted medical standards and consistent with the participant care needs including level of care and advanced care planning principles.
- Collaboration with the PACE Program's Medical Director to review and respond to appeal requests, ensuring issuance of a written determination consistent with the PACE program policies.
Visa & Work Authorization
- This position is not eligible for sponsorship.
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This listing is sourced directly from IntusCare's careers page and normalized into a canonical job model.