Clinical Operations Manager for Healthcare Utilization

7 days ago


Centennial, Colorado, United States CommonSpirit Health Mountain Region Full time
Company Overview

CommonSpirit Health Mountain Region is a leading nonprofit health system committed to building healthier communities and advocating for those who are vulnerable.

We deliver high-quality care through our 20 hospitals, urgent care centers, home care services, and over 240 physician practices in Colorado, Utah, and Kansas.

Career Opportunity

We are seeking an experienced Clinical Operations Manager to lead our Utilization Management team. As a key member of our Care Coordination model, you will oversee the development, implementation, and evaluation of our Utilization Management Program.

Your primary responsibilities will include:

  • Program Development: Collaborate with the Division Director to develop strategies that meet departmental and CommonSpirit Health goals.
  • Staff Management: Direct and manage a team of Utilization Management staff to ensure operational performance standards are met.
  • Policies and Procedures: Oversee the development and implementation of UM policies, procedures, and processes.
Qualifications

To be successful in this role, you will need:

  • A Bachelor's degree in Nursing, Healthcare Administration, or an advanced clinical degree.
  • A minimum of 3 years of clinical case management experience, including utilization management, denial management, and care coordination.
  • 5 years of progressively responsible management experience, with extensive knowledge of managed care and program planning.
Benefits

We offer a comprehensive Total Rewards package, including:

  • Competitive salary: $50.44 - $85.10 per hour.
  • Comprehensive medical, dental, and vision benefits.
  • Retirement account options with a generous employer match.
  • Tuition reimbursement and student loan forgiveness programs.


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