Job Description:

Select Health is a community health plan serving more than 1 million members. Select Health’s line of businesses include Medicare, Medicaid, FEHB, Marketplace Qualified Health Plans, and fully funded and self-funded Commercial Employer plans.

This leader is responsible for the development, implementation, evaluation, and operational management of care management programs for the line of business(s) which this position oversees. The position requires an understanding of care management industry benchmarks, best practices and regulatory environment for the line of business function.

This position leads a team of five managers, and associated frontline caregivers, and strategy as assigned to this role.



The role is hybrid and will require travel as needed, primarily to areas where Select Health conduct business. We will consider candidates who live in, or are willing to relocate to, Utah, Idaho, Nevada, Colorado and are within a reasonable commuting distance to a Select Health care site.​ Currently, we are not hiring remote workers in the following states: CA, CT, HI, IL, NY, RI, VT, and WA.

Essential Functions

Supports development and refinement of tools, processes and systems to optimize medical management, clinical outcomes and member satisfaction in order to provide a seamless experience for our members as they cross the full continuum of their healthcare journey. Oversees program components related to care management and utilization review for the specific line of business, across all service areas and multiple states and assists the department leader in scaling care management and utilization review operations that supports membership growth, acquisitions and expansion into new service areas in a strategic and efficient way.Ensures Select Health offers competitive programs, monitors medical expense trends for the product line and works with senior leadership to evaluate or add programs to impact trends. Uses a data-driven approach to assess utilization management and care management operations and make program recommendations.For Interdisciplinary Care Management, develops structures and processes to facilitate care coordination among treating physicians, pharmacists, behavior health professionals, and other treating providers in multidisciplinary care planning and care delivery.Collaborates with our network partners through joint operating committees to assure program development and integration and coordinates activities across department lines to meet operational objectives of Select Health.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 ensurealignment 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 whichmay include corrective action and termination.Facilitates coordinated clinical and non-clinical care in collaboration with interdisciplinary teams and providers to enhancepatient 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 patientexperience.Ensures compliance with regulatory agencies regarding discharge planning, conditions of participation and care

Skills

LeadershipCommunicationHealth plan functionsCare managementPerformance managementChange management

Qualifications

Minimum Qualifications

Bachelor's or master’s degree in clinical specialty, such as Nurse, LCSW, Nurse Practitioner, Physician's Assistant, Physical or Occupational Therapy. Education is verified.Current associated clinical license in state of Utah and other states where Select Health does businessExperience working in a managed care environment and have familiarity with the regulatory environment pertinent to the Line of Business (LOB) they will oversee (e.g. NCQA, CMS).Three years of clinical experience, preferably in a variety of settings.Previous leadership or management experience in a managed care environment including organizational and program development skills requiring demonstrated knowledge of care management, utilization management and insurance industry.Experience with financial reporting and analysis, preferably in a managed care setting.Demonstrated problem-solving ability.Demonstrated excellent verbal, written and interpersonal communication skills.Demonstrated public speaking and presentation skills.Demonstrated Experience Leading a team

Preferred Qualifications

Certified Care Management CertificationExperience leading an ambulatory care management team within a managed care environment

 

Additional Information

This is an exempt, full-time position. 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. This plan enables Intermountain Health to provide leaders with an additional performance compensation opportunity. The AP4P award opportunities are calculated as a percentage of your base salary. Awards are paid out based on attainment of selected Board-approved goals. 

Physical Requirements:

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, and members 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 be expected to sit or stand in a stationary position for a long time.

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. 

$58.62 - $90.48

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.

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.