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Manager, Medicaid Care Management

3 months ago

Murray, United States Intermountain Health Full time

Job Description: SelectHealth is a not-for-profit community health plan serving more than 1 million members in Utah, Idaho, and Nevada.

As part of an integrated system with Intermountain Healthcare, we share a mission of "Helping people live the healthiest lives possible" to ensure our members and the communities we serve have the highest quality healthcare at the lowest possible cost.

SelectHealth’s line of businesses (LOB) include Medicare, Medicaid, FEHB, Marketplace Qualified Health Plans and fully-funded and self-funded Commercial plan.

The Healthy Connections Program Manager reports to the Health Services Manager, Director or AVP to successfully manage the daily operations of a specific care management or utilization review program. Communicates and demonstrates the of value of SelectHealth programs to internal and external stakeholders and members eligible for the program. The manager will serve as a subject matter expert in executing the program and adhering to any applicable regulatory requirements. Promotes collaboration across functions and establishes effective interface with system stakeholders and members toward enhancing performance and program delivery Hires and manages performance of Care Managers, Community Care Transitionist or Utilization Reviews who support members enrolled in the program Assists in program development and serves as a SME/resource for clinical process and programmatic needs. Promotes a continuous improvement orientation- works to address gaps and promotes program adherence with requirements and monitoring of internal processes and related metrics Demonstrates a strong clinical understanding of all aspects of Care and Disease Management programs or utilization management programs, functions and processes. Creates and presents reports and other information for stakeholders regarding program performance, including outcome measure and return on investment. Minimum Qualifications Bachelor’s degree in clinical specialty (e.g., Nursing, Social Work, Physical Therapy, Occupational Therapy, Speech Therapy) Experience in insurance/managed care or care delivery settings Excellent communication and teaming skills Ability to work complex projects and manage deliverables Preferred Qualifications At least one year of care management or utilization management experience Project management and organization skills Physical Requirements: Anticipated job posting close date: 07/22/2024

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. $43.67 - $67.41

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 packages for our

Idaho, Nevada, and Utah based caregivers , and for our

Colorado, Montana, and Kansas based caregivers ; and

our commitment to

diversity, equity, and inclusion

. 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.

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