Location: Boise, Idaho
St. Luke's Health System seeks an Administrator, Utilization Management to join our team.
The Administrator, Utilization Management works directly with St. Luke's Health System Care Management VP and key system stakeholders to develop strategies that ensure achievement of health system goals. The Administrator must possess strategic vision, excellent communication skills, proven motivational capabilities, have an executive presence, and have a demonstrated record of accomplishment for delivering results and attaining goals.
The Administrator for Utilization Management leads the execution of St. Luke's Health System (SLHS) care management program across the acute care system, ensuring processes and standards are implemented and successful at the individual hospital level. The Administrator Utilization Management is critical in achieving desired, sustainable outcomes in SLHS facilities through model alignment, process improvement, and education. The Administrator Utilization Management will develop plans and drive execution and results at the system level. The Administrator Utilization Management works directly with key system leaders, and hospital stakeholders to develop strategies that ensure achievement of SLHS goals.
- Provides direct leadership, oversight, and accountability for the operational effectiveness of Case Management and Utilization Review at the system and facility level.- Works collaboratively with care management VP, and other system and hospital leaders (COOs, CFO, CMOs, CNOs, CDI, Quality, - Performance Improvement, Revenue Cycle, VP Contracting, Ethics, Legal, Clinics, Health Partners, Population Health, Post-Acute) as a resource and advisor, proactively analyzing data, aligning goals to improve operational, clinical, quality, and patient satisfaction outcomes. - Actively partners with SVP, Chief Physician Executive and Chief Physician Advisor on effective utilization management, CDI and support for the Utilization Management Committee. - Identifies opportunities to optimize performance, build internal competencies and create a more rigorous approach to case management throughout the system, bringing a strong focus on standardization, accountability, and appropriate utilization of resources. - Assumes ultimate accountability for regulatory compliance; adherence to SLHS established policies, practices, efficiencies; and effectiveness of clinical Case Management, Utilization Management, and Social Work functions within the system's hospitals. - Ensure controls are established to maintain compliance with all payer contract requirements.- Collaborates with SLHS Care Management VP and system/facility based finance business partners to develop and implement measurement tools to track and trend operational efficiency and financial performance. - Oversight of all utilization management operations and appeals and grievances consistent with SLHS integrated health delivery model and payer functions.- Provides growth and development opportunities to employees, mentors developing leaders and addresses succession planning. - Ensures a high level of collaboration within a highly matrixed team environment in order to coordinate activities, review work, exchange information, and resolve problems. Promotes collaboration among various stakeholders to achieve optimal results. Fosters a culture of partnership. - Partners with others to lead efforts to connect with community resources and within the local post-acute care industry in order to develop relationships and to stay connected to industry changes and new regulations.- Executes the strategic plan of the SLHS Case Management program at the system and facility level. - Drives business decisions with data analytics Develops a culture of high performance and continuous improvement that values learning and a commitment to quality. - Performs other duties as assigned.
- Education: Master's degree or Bachelor's degree + 2 years additional experience- Experience: 10 years' relevant experience
Why St. Luke's
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.
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.