This job is archived
Correctional Medicine Medical Director Utilization Management Needed in Atlanta, GA
Nashville, Tennessee, United States
Job Summary
Occupation
Physician
Specialty
Medical Director
Degree Required
MD/DO
Position Type
Permanent/Full-Time
Work Environment
Hospital
Clinic/Private Practice
Location
Atlanta, Georgia, United States
Visa Sponsorship
No
Job Description
Last Update:
9/19/21
Here at Wellpath, everything that we do is about taking care of people - our patients, our staff and our partners. We are committed to making a difference by providing hope and healing to vulnerable patients in challenging clinical environments. Our talented, compassionate team thrives in an autonomous environment, is empowered and supported by education, training and the resources to practice healthcare the way it is meant to be and strives to "Always Do The Right Thing!"
Overview
Provides leadership in the operational areas of utilization review, case management, quality improvement and related policy and practice initiatives within the assigned area.
Qualifications
Education
Experience
Licenses/Certifications
Wellpath is an EOE/Minorities/Females/Vet/Disability Employer
Overview
Provides leadership in the operational areas of utilization review, case management, quality improvement and related policy and practice initiatives within the assigned area.
Qualifications
Education
- Medical Doctor (M.D.) or Osteopathic Doctor (D.O.) from an accredited university
Experience
- One (1) year of experience in utilization management is required.
- Excellent communication and organizational skills required.
- Experience in Performance and/or Quality Improvement preferred.
Licenses/Certifications
- Current license in state of employment to practice medicine
- Ensures that inpatient concurrent reviews and offsite service requests are performed using nationally recognized criteria and evidence based standards.
- Handles all management level responsibilities for UM staff, including performance reviews, employee development, hiring, coaching, counseling, and retention.
- Provide feedback, including regular one-on-ones and annual performance evaluations, for direct reports.
- Provides leadership guidance and acts as a resource to the RNs and UM schedulers.
- Oversees UM process improvements as needed to ensure quality and service excellence as it pertains to Utilization Management.
- Leads team in assuring resources are optimally used to facilitate patient care goals, appropriate cost and length of stay.
- Utilizes data research to develop and implement programs to reduce length of inpatient stays and decrease ED admissions.
- Evaluates and recommends policy improvement related to utilization review system, including appropriate resource utilization and identification of non-billable days.
- Provides UM updates and is an as needed participate in AA, DON, HSA, and provider meetings.
- Participates in New Employee Orientations for Regional Office staff as requested. Provides education to new staff regarding Inpatient and Offsite services and develop training materials for new staff as it pertains to Utilization Management.
- Provides statistical data as it applies to financial impact for offsite services.
- Establish and monitor progress towards goals for UM program, including turnaround times, timeliness, and quality of reviews, training and physician outreach efforts.
- Daily huddles to discuss ongoing issues, concerns and problem solve for resolution.
- Oversees Transplant Cases.
- Maintains offsite service and UM tracking/reporting as required by contract and regional leadership highlighting issues/trends of high priority.
- Facilitate regular meetings with partner hospital clinical regarding offsite services.
Wellpath is an EOE/Minorities/Females/Vet/Disability Employer