Medical Director Utilization Management

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Compensation Range:

Anticipated compensation range of $238,631.00 - $292,323.00 / Year depending on qualifications and experience.

Department:

875100 Case Management

Expectations:

Huntington Hospital has a utilization management program to ensure the appropriate utilization of all services provided to Hospital patients. The UM Medical Director serves as a Physician Advisor and performs administrative services related to status management, denials Management, and the education of Huntington physicians on optimal utilization of resources, status determination, and coding opportunities. This role will report to the Vice President of Quality and Clinical Operations, and will work collaboratively with the Vice President of Revenue Cycle, Director of Case Management, Utilization Management case managers, and the medical staff leadership to optimize patient status, clinical documentation, and hospital resource utilization.

EDUCATION:
MD or DO, board certified, preferably in primary care specialty (internal medicine, family medicine, Emergency Medicine).

EXPERIENCE/TRAINING:
Minimum 5 years' experience in utilization management. Prior experience as Medical Director preferred. CCDS or other clinical documentation training preferred. Familiarity with MCG/Interqual or other equivalent placement status tool preferred.

LICENSES/CERTIFICATIONS:
Required:
Current California Doctor of Medicine (MD)/Doctor of Osteopathic Medicine (DO) License
Current Drug Enforcement Administration (DEA) number issued by DEA
Current National Provider Number (NPI) issued by Center for Medicare and Medicaid Services (CMS)

Worker Type:

Regular

Full time

Shift:

Days