Utilization Management Director leads and directs the utilization review staff and function for a healthcare facility. Determines policies and procedures that incorporate best practices and ensure effective utilization reviews. Being a Utilization Management Director manages and monitors both concurrent reviews to ensure that the patient is getting the right care in a timely and cost-effective way and retrospective reviews after treatment has been completed. Provides analysis and reports of significant utilization trends, patterns, and impacts to resources. Additionally, Utilization Management Director consults with physicians and other professionals to develop improved utilization of effective and appropriate services. Requires a master's degree. Typically reports to top management. Typically requires Registered Nurse(RN). The Utilization Management Director manages a departmental sub-function within a broader departmental function. Creates functional strategies and specific objectives for the sub-function and develops budgets/policies/procedures to support the functional infrastructure. Deep knowledge of the managed sub-function and solid knowledge of the overall departmental function. To be a Utilization Management Director typically requires 5+ years of managerial experience. (Copyright 2024 Salary.com)
St. Luke’s Health System is seeking a Post-Acute Care Advisor to join our Health Partners team. This role offers a variety of flexibility including the ability to work remotely (within healthcare parameters) with no on-call obligations!
POSITION SUMMARY
The Care Advisor works with physicians and multidisciplinary care team members to assess patient needs and develop a care plan. The Care Advisor uses assessment skills and appropriate risk assessment tools to identify patients with actual or potential health care needs that would require post-acute care coordination. This position collaborates with interdisciplinary teams in establishing mutual goals based on the patient's needs or problems. The Care Advisor evaluates, compares and interprets ambiguous and changing clinical patient data. This individual explores patient's understanding and knowledge of current health status.
WHAT WILL I DO? This position will decrease variability and waste by standardizing rehabilitation and medical care in coordination with hospitals and post-acute care facilities. You will actively manage the engagement of hospital care teams and the care teams in skilled nursing facilities. This is a system-wide role that supports hospital discharge planning and enhances coordination of post-acute care and outcomes in a cost-effective manner. The person needs to have strong interpersonal skills, be very detailed, and have excellent communication skills. Also, must be willing to have fun, work hard, and have a true passion to help solve problems and help others!
ABOUT ST. LUKE’S HEALTH PARTNERS
St. Luke’s Health Partners is an Idaho-based financially and clinically integrated network of providers who share a vision to help its members achieve the best possible health at the lowest total cost of care. SLHP is accountable for the management of medical spend and quality outcomes of defined populations through value-based agreements with payer partners. The selective network of nearly 2,800 providers is currently serving more than 160,000 Idahoans.
WHY ST. LUKE’S?
St. Luke’s Health System is Idaho’s largest employer and most awarded health system, with a medical staff of over 1,800 physicians and advanced practice providers. Made up of eight hospitals around central and southern Idaho, we are proud to be the only locally owned and operated, physician-led, not-for-profit health system in the state. St. Luke’s has been awarded as one of the Top 15 Health Systems in the country for the fifth consecutive year, designated by Truven Health Analytics. We are committed to providing high quality patient care and positively impacting the lives of those in our community. St. Luke’s enjoys an outstanding reputation as both a quality employer and a superior healthcare organization.
Preferred Qualifications:
A strong, talented staff is at the heart of St. Luke’s Health System. We are the state’s largest employer with more than 15,000 employees and a medical staff of more than 1,800 physicians and advanced practice providers. We’re proud of our people who deliver skilled, compassionate care every day, and are looking to add dedicated individuals who will continue this same tradition of excellence.
For more information, please contact Julie Leguineche at leguinej@slhs.org
ABOUT TWIN FALLS
Located in Southern Idaho, just under two hours from Boise, Twin Falls offers four distinct seasons and is best known for Shoshone Falls - "Niagara of the West" - and bountiful outdoor adventures. Adventure seekers here can enjoy whitewater rafting, kayaking, rock-climbing and BASE jumping from Perrine Bridge. Twin Falls has a thriving agriculture-based economy, which powers its reputation as a preferred location for food science, production and processing companies. Local schools receive strong support from the community in both academics and sports, while also enriching the community's arts and culture scene. With a low crime rate, good schools and endless opportunities for the outdoor enthusiast, you’ll find Twin Falls is unhurried, unspoiled and unassuming.
Learn more about what the Magic Valley has to offer you:
City of Twin Falls | Perrine Bridge | Shoshone Falls | Snake River Canyon Rim Trails | Dierkes Lake | Idaho Heritage Museum | Herrett Center for Arts and Sciences | Orpheum Theatre | Faulkner Planetarium | Twin Falls Parks and Rec | Twin Falls Golf Club | Farmer's Market | Pomerelle Ski Resort | Balanced Rock | City of Rocks | Thousand Springs | Magic Valley Symphony | Sawtooth National Forest
About Boise
Known as the "City of Trees," Boise is Idaho's capital city—both a cultural center and a playground for those who love the outdoors. A vibrant downtown area affords fine dining, theatre, music, and college and semi-professional sports. Downtown Boise's main attractions include the Idaho State Capitol, the classic Egyptian Theatre, the Boise Art Museum, Julia Davis Park and Zoo Boise. The Greenbelt follows the beautiful Boise River corridor for more than 30 miles, and the Boise foothills are home to miles of hiking and biking trails.
Learn more about what the City of Trees has to offer you:
St. Luke’s Health System | Boise Convention and Visitors Bureau | Boise Parks and Recreation | Boise Museum Association | Boise Music Festival | Boise Philharmonic | Downtown Boise Restaurants | Boise Valley Economic Partnership | Hyde Park events | Treefort Music Festival | First Thursdays | Alive After Five | Capitol City Public Market | Runs and Triathlons | Shakespeare Festival | Sawtooth National Forest | Visit Idaho.org
*St. Luke’s is an equal opportunity employer without regard to race, religion, color, gender, gender identity, sexual orientation, age, national origin, disability, veteran status, or any other status or condition protected by law.
0 Utilization Management Director jobs found in Nampa, ID area