Executive Director, Enterprise Utilization Management

Beth Israel Lahey Health

Boston (MA)

On-site

USD 180,000 - 210,000

Full time

14 days+

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Job summary

Beth Israel Lahey Health (BILH) seeks an Executive Director of Utilization Management to lead the transformation of UM from a decentralized model to a centralized, enterprise function across 15 hospitals. The role partners with senior clinical and operational leaders to align UM initiatives with care coordination, length of stay optimization, and payer collaboration.

You will develop enterprise-wide UM strategies, standardize policies, manage vendor relationships (InterQual, MCG, and related

Qualifications

Bachelor's degree in Nursing, Healthcare Administration, Health Information Management, or related healthcare field is required.
Master's degree strongly preferred.
Active RN license preferred.
ACM or CCM credentials strongly preferred.
Minimum 8 years of progressive leadership experience in Utilization Management, Case Management, or Revenue Cycle Operations.
Minimum 3 years in senior leadership roles with multi-site responsibility.

Responsibilities

Lead enterprise UM strategic plans aligned with clinical, financial, quality goals.
Evaluate and manage UM vendors and technology solutions (InterQual, MCG, or similar).
Standardize UM policies and transition to centralized enterprise model.
Oversee CMS Conditions of Participation compliance.
Develop enterprise dashboards and ROI metrics for UM program.
Build consensus among site leadership for centralized UM processes.