Care Management Director
hace 2 días
Salt Lake City
The Care Management Director (also referred to as the Healthy Connections Director) is a clinical leader that oversees the design, execution, and optimization of specified care management programs and functions for all lines of business at Select Health. This role ensures high quality, cost effective care through data driven evaluation, regulatory compliance, and alignment with industry best practices. The Director oversees interdisciplinary teams, guides patient care coordination, develops care management protocols, and strengthens collaboration with providers, payers, and internal partners. Additional responsibilities include shaping care management strategy, supporting technology and workflow advancements, and fostering a culture of quality, accountability, and compassionate service. As a clinical and operational leader, this position drives strategic planning, endorses key performance indicators, promotes efficient resource use, and ensures programs support positive patient outcomes, service excellence, and organizational performance. Essential Functions • Oversees strategic planning, daily operations, and standards of care to ensure efficient, safe, and fiscally responsible service delivery., • Applies data-driven evaluation to monitor performance and guide improvements., • Builds community partnerships to ensure access to resources and coordinated care., • Coordinates clinical and non?clinical care with interdisciplinary teams for optimal outcomes., • Ensures compliance with regulatory, accreditation, and contractual standards., • Leads in ensuring members receive the right care, at the right time, in the right setting, while supporting medical necessity, quality, and cost?effective utilization of benefits., • Improves tools, systems, and workflows for medical management efficiency and member satisfaction., • Leads workforce planning, recruitment, retention, staffing, leadership development, and succession planning., • Manages budgets, cost analysis, medical expense trends, and aligns with financial goals., • Models professionalism and fosters accountability, collaboration, and continuous improvement., • Oversees care management and utilization review across multiple lines of business and regions., • Oversees HR functions including hiring, onboarding, training, performance management, and disciplinary actions., • Partners with physicians and leaders to achieve clinical, operational, financial, and service excellence., • Strengthens partner relationships to support service utilization, contracts, and joint programs., • Supports high risk and complex members' medical, behavioral, and social needs through holistic, person-centered care addressing barriers such as Social Determinants of Health., • Supports patient satisfaction, quality outcomes, and service excellence, including care transitions. Skills • Leadership & Strategic Planning, • Communication, • Health plan functions, • Utilization review, • Care Management & Social Work, • Performance management, • Change management, • Patient Satisfaction, • Nursing & Care Coordination, • Budgeting, • Collaboration, • Regulatory Requirements, • Microsoft expertise Location This position is hybrid and will require regular in-office time at Select Health's main campus in Murray, Utah. Additional travel may be required occasionally. Minimum Qualifications • Active Registered Nurse (RN) license or Licensed Clinical Social Worker (LCSW) license in state of practice., • Bachelor of Science in Nursing (BSN) OR Master of Social Work (MSW) from an accredited institution (degree verification required)., • Leadership experience in managed care, including Utilization Review, Care Management, or related clinical operations, with ability to develop programs, direct teams, and collaborate with physicians and interdisciplinary partners., • Three years of clinical experience plus HMO/UM experience in a health plan or integrated delivery system., • Experience with financial analysis, reporting, and operational evaluation, preferably in managed care., • Demonstrated skill in strategic planning, problem?solving, developing clinical strategies, and implementing operational improvements., • Excellent verbal, written, interpersonal, and presentation communication skills. Preferred Qualifications: • Care Management Certification, • Proven ability to build payer relationships, evaluate technology solutions, and support cross?continuum care strategies., • Strong knowledge of healthcare regulations, reimbursement, contractual requirements, and NCQA standards. Additional Information Pay offers are determined by prior years of relevant experience within the established pay range. In addition to the annual salary, to show our commitment to you and assist with your transition, we may offer a sign-on and relocation bonus when applicable. With this position, you are eligible to participate in the Annual Pay for Performance (AP4P) Plan. Physical Requirements • Ongoing need for employee to see and read information, 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 equipment with precision and accuracy. This, • includes frequent computer use for typing, accessing needed information, etc., • May have the same physical requirements as those of clinical or patient care jobs when the leader takes clinical shifts., • For roles requiring driving: Expected to drive a vehicle which requires sitting, seeing, and reading signs, traffic signals, and other vehicles. Location: SelectHealth - Murray Work City: Murray Work State: Utah Scheduled Weekly Hours: 40 The hourly range for this position is listed below. Actual hourly rate dependent upon experience. $59.50 - $91.84 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.
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