Medical Director of Care Coordination
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About The Position
As the Medical Director of Care Coordination, you will be responsible for writing reviews, managing denial mitigation, and overseeing utilization management. You will create presentations and communicate effectively with a multi-disciplinary team, including learners. Additionally, you will conduct professional peer-to-peer conversations with insurance company medical directors to ensure optimal patient care and resource utilization. This position acts as a physician executive to ensure the appropriate and efficient medical management of cases while assuring the quality of care is upheld as it relates to the primary and secondary review process. This position provides guidance on an individual case and aggregate level to cultivate efficiency related to patient care delivery. This position provides medical case review, utilization and quality review and provides recommendations, advice and liaison services concerning quality and cost-effective patient care. This position collaborates with hospital executive leadership, medical staff including resident physicians, nursing leadership and support staff. It works in conjunction with hospital executive leadership to optimize length of stay and efficiently manage resources. This position promotes improving documentation and coding and ensuring compliance with appropriate levels of care. This position has responsibility for providing leadership, direction, and administration of medical management, as well as the integration, coordination, and improvement of clinical care and patient safety for designated healthcare operations. Serves as a member of the facility executive leadership team for designated healthcare operations, building and supporting effective collegial relationships with stakeholders and ensuring optimal operating effectiveness and strategic positioning.
