Utilization Management Analyst

Dignity Health, one of the nation’s largest health care systems, is a 22-state network of more than 9,000 physicians, 63,000 employees, and 400 care centers, including hospitals, urgent and occupational care, imaging and surgery centers, home health, and primary care clinics. Headquartered in San Francisco, Dignity Health is dedicated to providing compassionate, high-quality, and affordable patient-centered care with special attention to the poor and underserved..  

One Community. One Mission. One California

The incumbent in this position supports the design, implementation and maintenance of clinical quality and outcome analytical systems for the Utilization Management Hub. This position provides technical support, statistical analysis and report generation. This position will focus on the retrieval of financial and clinical information at the patient level, including summarization of results to identify underlying trends. This position requires an expert understanding of medical record data, risk/severity adjustment systems and clinical as well as population based research methodologies. The incumbent will be required to collaborate with the System Care Coordination Leadership, Hospital Care Coordination Leadership, Utilization Management Hub Leadership, Quality Management and various other departments in the production of indicators and reports which incorporate measures of utilization management, clinical denials and department productivity.

• Ensure that all actions taken and methods used to produce the results outlined above incorporate and promote the Mission and Philosophy of CommonSpirit Health. The incumbent will be responsible for supporting the structures and processes necessary for providing clinically based health care information and analytic resources for clinical quality and performance improvement.
• Provide comprehensive planning assignment implementation, management and evaluation of assigned projects to meet the goals and objectives of Utilization Management and other departments as appropriate.
• Prepare written reports and make oral presentations as requested.
• Demonstrate initiative and personal accountability for actions using judgment and insight to solve problems and find better or more efficient ways to do things.
• Holds self and other accountable for ethical behaviors.
• Adapts to change, recognizes and appreciates the value of differing perspectives, develops innovative ideas and solutions, modifies plans and objectives given changing priorities or environment.