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Utilization Management

Mercy Healthcare Rancho Cordova, California
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The posted compensation range of $34.50 - $44.30 /hour is a reasonable estimate that extends from the lowest to the highest pay CommonSpirit in good faith believes it might pay for this particular job, based on the circumstances at the time of posting. CommonSpirit may ultimately pay more or less than the posted range as permitted by law.

Requisition ID 2024-388291 Employment Type Full Time Department Utilization Review Hours/Pay Period 80 Shift Day Weekly Schedule 0800-1630 Remote No Category Risk and Compliance
Overview

Dignity Health one of the nation’s largest health care systems is a 22-state network of more than 9000 physicians 63000 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. For more information please visit our website at www.dignityhealth.org. You can also follow us on Twitter and Facebook.


Responsibilities

The incumbent in this position supports the design, implementation and maintenance of clinical quality and outcome analytical systems for Mercy Healthcare. 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 members of NSSA Regional Health Services Research (HSR), Utilization Management, Quality Management and various other departments, in the production of indicators and reports which incorporate measures of resource consumption (costs), clinical efficacy, and health and service outcomes.


Qualifications

Required:

  • 3 years analytical experience using analytical tools, computers, and data bases
  • Bachelor’s Degree - Bachelor's Degree or equivalent combination of applicable experience and education may be accepted at the hiring manager's discretion
  • Proficiency with establishing and maintaining relational databases
    Proficiency with personal computer operations and software (Word, Excel, Access, PowerPoint)

Preferred:

  • Clinical experience with quality assurance/improvement is desirable, preferably as an RN, LVN, Pharmacist, Radiology Technologist, Rehabilitation Therapist, Respiratory Therapist, Laboratory Technologist
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CommonSpirit Health™ is an Equal Opportunity/Affirmative Action employer committed to a diverse and inclusive workforce. All qualified applicants will be considered for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, marital status, parental status, ancestry, veteran status, genetic information, or any other characteristic protected by law. For more information about your EEO rights as an applicant, please click here.

CommonSpirit Health™ will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor’s legal duty to furnish information. 41 CFR 60-1.35(c). External hires must pass a post-offer, pre-employment background check/drug screen. Qualified applicants with an arrest and/or conviction will be considered for employment in a manner consistent with federal and state laws, as well as applicable local ordinances, ban the box laws, including but not limited to the San Francisco and Los Angeles Fair Chance Ordinances. If you need a reasonable accommodation for any part of the employment process, please contact us by telephone at (415) 438-5575 and let us know the nature of your request. We will only respond to messages left that involve a request for a reasonable accommodation in the application process. We will accommodate the needs of any qualified candidate who requests a reasonable accommodation under the Americans with Disabilities Act (ADA). CommonSpirit Health™ participates in E-Verify.