Correctional Care | Committed Careers | Corizon Health

We have an exceptional opportunity for a Statewide Utilization Medical Director to join our healthcare team at the Regional Offices based in Hanover MD.

Job Summary

The Statewide Medical Director of Utilization Management is responsible for the evaluation of all outpatient referrals and inpatient direct admissions for medical appropriateness. He or she will utilize Interqual reviews as provided by Corizon Health’s utilization management nurses along with Corizon Health’s standard medical guidelines to determine whether a request will be approved as an offsite encounter or if an alternate treatment plan should be employed; also taking severity of illness, acuity and risk of mortality into account in making such determinations.

The Statewide Medical Director of Utilization Management is also responsible for the review and approval of non-formulary drug prescriptions. In partnership with Corizon Health clinical pharmacists and physician specialists, he or she will evaluate non-formulary drug requests for medical appropriateness and compliance with Corizon Health’s preferred non-formulary drug list.

All of Corizon Health’s standard medical guidelines and preferred drug lists comply with applicable Federal, State, and Local regulations, Department of Corrections (DOC) or jail contract requirements, and American Correctional Association (ACA) / National Commission on Correctional Health Care (NCCHC) standards.

Corizon Health’s Utilization Management Appeals Committee provides oversight of the utilization review process and ensures that all decisions can be challenged by the requestor and re-evaluated by an independent body.

Qualifications

* US Residency completion required and Board Certification preferred
* Five (5) years of progressively related work experience preferred
* Strong written and verbal communication skills
* Team oriented and a collaborative mindset
* Requires broad clinical knowledge with good clinical background, analytical and decision making skills
* Knowledge of health care delivery system
* Knowledge of utilization management, InterQual, DRGs
* Active licenses in multiple state contracts where services are provided

Benefits offered by Corizon Health

* 5 Weeks Paid Time Off
* No weekends or evenings
* Minimal on-call
* No overhead
* Medical & Dental
* Company matched retirement plan
* Continuing Medical Education allowance
* Paid malpractice

Corizon Health provides patients with high quality healthcare and reentry services that will reduce recidivism and better the communities where we live and work. We are dedicated to meeting the needs of the growing number of incarcerated persons with physical and mental illness and the professionals who care for them. More healthcare professionals are finding the stability and advancement they desire at Corizon Health.

This position may require a background check, security clearance, and/or drug screening.

Corizon Health is an Equal Opportunity Employer. In compliance with federal and state employment opportunity laws, qualified applicants are considered for all positions without regard to race, gender, national origin, religion, age, sexual orientation, disability, Vietnam era veteran, or disabled Veteran status.