Director, Care Management & Utilization Review

Intermountain Health; United States; On-site; USD 120,000 - 190,000; Full time

Job summary

Intermountain Health seeks a leader to provide leadership and administrative oversight across multidisciplinary teams to coordinate patient services throughout the continuum.

The role collaborates with Medical Staff, Nursing, Clinical Services, and Revenue Cycle leadership to promote high-quality care, financial objectives, and leadership development. Travel across enterprise may be required.

Qualifications

• Current RN license or LCSW in state of practice.
• BSN or MSW from an accredited institution (degree verification required).
• Care Management Certification within 24 months of hire or promotion.
• Demonstrated management experience in Care Management or related area.
• Experience in hospital or ambulatory case management, social work, or related areas requiring knowledge of the current healthcare environment, healthcare regulatory matters and healthcare reimbursement.
• Demonstrated knowledge and oversight of government regulations, contractual requirements, and NCQA accreditation standards.

Responsibilities

• Oversees strategic planning, day-to-day operations, and standards of care. Promotes efficient, fiscally responsible, effective, safe, and compassionate care.
• Accountable for fiscal management, including budget development, cost center analysis, and ongoing monitoring to ensure alignment with organizational goals.
• Models professionalism and fosters a supportive environment. Leads workforce planning efforts focused on recruitment, retention, staffing, development, and succession planning.
• Oversees human resource functions including interviewing, hiring, onboarding, training, and performance management which may include corrective action and termination.
• Facilitates coordinated clinical and non-clinical care in collaboration with interdisciplinary teams and providers to enhance patient outcomes.
• Partners with physicians to achieve clinical, operational, financial, and service excellence.
• Ensures processes and programs support patient satisfaction and service quality goals.
• Builds community relationships and promotes the integration of community resources to enhance the overall patient experience.
• Ensures compliance with regulatory agencies regarding discharge planning, conditions of participation and care management.

Skills

Care Management & Social Work

Leadership & Strategic Planning

Patient Satisfaction

Nursing & Care Coordination

Budgeting

Communication

People Management

Collaboration

Community Outreach

Regulatory Requirements

Education

BSN

MSW

Care Management Certification

Job description

Intermountain Health seeks a leader to provide leadership and administrative oversight across multidisciplinary teams to coordinate patient services throughout the continuum.

The role collaborates with Medical Staff, Nursing, Clinical Services, and Revenue Cycle leadership to promote high-quality care, financial objectives, and leadership development. Travel across enterprise may be required.