Utilization Management Director jobs in Columbus, GA

At St. Francis-Emory Healthcare, we recognize that our patients deserve qualified, engaged, and competent healthcare professionals. And we know that our healthcare professionals deserve a safe working environment, visible and supportive leaders, and opportunities to grow and develop in their chosen disciplines. The heart of St. Francis is in its people, making our hospital a family that only the best are invited to join. If you feel that your skills and compassion fit with our vision for healthcare, we invite you to apply today. 

Manages Case Management Department (includes Bed Board/Clinical Intake, Disease Management, Social Services, Discharge Planning, Precertification, and Denial management; plans, organizes, and directs all related functions and activities (internal and external); establishes goals, objectives, standards of performance; develops operating policies and procedures; interprets hospital policies, standards and regulations to appropriate staff, patients, medical staff and public. 

Evaluates the effectiveness of Case Management services related to reimbursement for inpatient and outpatient services.  Coordinates negotiates, and procures services and resources for the management of the care of complex patients to facilitate the achievement of quality and cost-efficient patient outcomes. Looks for opportunities to reduce cost while ensuring the highest quality of care is maintained. Develops clinically-based case management, discharge planning, and care coordination to facilitate the delivery of cost-effective quality healthcare through the identification of appropriate utilization of resources across the continuum of care.

Company Culture

Now a 376-bed, two-campus regional health system, St. Francis has earned a national reputation for outstanding quality of care. To further expand care, in January 2016 St. Francis Hospital became part of LifePoint Health, a leading healthcare company dedicated to Making Communities Healthier®. LifePoint paid off all of St. Francis’ financial obligations, including its loan from the U.S. Department of Housing and Urban Development (HUD).

As part of LifePoint, St. Francis continues its existing charity care policies, and a local Board of Trustees ensures the community’s voice in the governance of the hospital. The hospital’s staff continues building upon the legacy of excellent healthcare St. Francis has established as well as exploring new ways to improve the health and wellbeing of the communities served. In addition, St. Francis is now a local taxpayer, providing a new source of tax revenues that benefits the community and helps support local projects, local schools and infrastructure in the Chattahoochee Valley. And, as it has since its founding, St. Francis continues to recognize the importance of “holy” when it comes to healing, placing priority on meeting the spiritual needs of patients, their families, and their friends through the Chaplain Services ministry and weekly services held in the hospital chapel.

Now, more than 65 years since its founding, St. Francis remains what the Columbus Ledger described that day as “A dream of mercy shared by people of all faiths.”

The Columbus Region, known locally as the Chattahoochee Valley, is comprised of seven counties: six in Georgia, and one in Alabama. Collective efforts continue to strengthen the region’s economy. The impact is clear in recent projects, such as the allocation of more than $100 million to fund cultural arts projects, vital infrastructure support, the 22-mile RiverWalk, and the Columbus RiverCenter. Over the last decade, the region has experienced the benefits of more than $2.8 billion in new capital investment and 18,000 new jobs.

Columbus is experiencing an arts and culture renaissance. From ballet to Broadway, being inspired by the arts is an important part of life in Columbus. Whether you enjoy the theater, live music, or an eye-opening exhibit, there’s truly something for everyone.

The area boasts diverse housing options from historic homes to walkable family neighborhoods to riverfront apartments to lakefront gated communities. Access to an area like this usually comes with a steep price tag, but here, affordable housing makes your dream home a reality. Best of all, the cost of living and commute time are well below the national average. Both historic and progressive, this unique region has somewhere amazing for everyone to live.