Director Utilization Mgmt (DO OR MD REQUIRED)

Wellpath•Lemoyne, PA

11h

About The Position

The Medical Director of Utilization Management leads and oversees utilization review, case management, quality improvement, and related policy and practice initiatives within their assigned area. They provide guidance and direction to medical staff in their efforts to ensure quality patient care and the appropriate utilization of medical services. The Medical Director of Utilization Management serves as a key liaison with external partners and stakeholders, and works collaboratively with internal teams to optimize care delivery and achieve operational goals.

Requirements

Medical Doctor (M.D.) or Osteopathic Doctor (D.O.) from an accredited university
One (1) year of experience in utilization management is required.
Excellent communication and organizational skills required.
Current license in state of employment to practice medicine

Nice To Haves

Experience in Performance and/or Quality Improvement preferred.

Responsibilities

Ensure the use of nationally recognized criteria and evidence-based standards for inpatient concurrent reviews and offsite service requests.
Manage UM staff including performance reviews, employee development, hiring, coaching, counseling, and retention.
Lead UM process improvements, facilitate patient care goals, and utilize data research to reduce length of inpatient stays and decrease ED admissions.
Evaluate and recommend policy improvement related to utilization review system, and provide UM updates and participate in meetings.
Establish and monitor progress towards UM program goals, maintain offsite service and UM tracking/reporting, and facilitate regular meetings with partner hospital clinical regarding offsite services.

Benefits

In addition to comprehensive benefits including medical, dental, vision, paid time off, and 401k, we foster a work, life balance for team members and their family to support physical, mental, and financial wellbeing including:
DailyPay, receive your money as you earn it!
Tuition Assistance and dependent Scholarships
Employee Assistance Program (EAP) including free counseling and health coaching
Company paid life insurance
Tax free Health Spending Accounts (HSA)
Wellness program featuring fitness memberships and product discounts
Preferred banking partnership and discounted rates for home and auto loans
Eligibility for perks and benefits varies based on employee type and length of service.
We are an Equal Employment Opportunity Employer
We are committed to fostering, cultivating, and preserving a culture of uniqueness.
We celebrate a variety of backgrounds and are committed to creating an inclusive environment for all employees.
We encourage you to apply! If you are excited about a role but your experience doesn’t seem to align perfectly with every element of the job description, we encourage you to apply.
Deadline to apply to this position is contingent upon applicant volume.
We are an Affirmative Action Employer in accordance with applicable state and local laws.
We are an Equal Employment Opportunity Employer
We are committed to fostering, cultivating, and preserving a culture of uniqueness.
We celebrate a variety of backgrounds and are committed to creating an inclusive environment for all employees.
We encourage you to apply! If you are excited about a role but your experience doesn’t seem to align perfectly with every element of the job description, we encourage you to apply.
Deadline to apply to this position is contingent upon applicant volume.
We are an Affirmative Action Employer in accordance with applicable state and local laws.