Summary

Responsible for medical staff leadership to the Utilization Management Committee (UMC) and the Case Management (CM) and Health Information Management (HIM)/Clinical Documentation Improvement Departments.
Leads and promotes processes for patients to receive medically necessary and high quality care throughout the continuum of care.
Stays abreast of professional best practices and community standards of care.
Assists Administration in reducing financial risks associated with denials that are due to providing medically unnecessary or preventable services and extended length of stays.

Education

Doctor of Medicine Degree (M. D. ) or Doctor of Osteopathic Medicine Degree (D. O. ). Prefer advanced degree in Business and/or Health Care Administration.

Experience

2 years in a physician leadership role. Prefer Utilization Management and hospital committee chair. Prefer demonstrated ability to work in a collegial role with members of the medical staff and to engage in education to hospital medical staff. Prefer successfully conducted physician to physician discussions with payers.

Certifications

Current State MD or DO License and an ABMS (American Board of Medical Specialties) Certification.