Medical Director Physician Advisor - Utilization Management Informatics

UNC Health•Morrisville, NC

1d•Onsite

About The Position

The HCS Medical Director of Utilization Management Informatics is an enterprise physician leadership role focused on effective use of clinical information technology and high-quality, efficient, clinically appropriate care. The position provides strategic and operational leadership for system-wide implementation and optimization of digital health tools and platforms, including Epic, with emphasis on the Eastern and Coastal regions, inpatient implementation and go-live support, physician engagement, workflow improvement, and clinical informatics initiatives. The Medical Director serves as a physician liaison among medical staff, clinical operations, information technology, and enterprise leadership. The role also provides physician leadership for integrating utilization-management processes into Epic workflows so that technology, clinical workflows, documentation, and utilization-management practices are aligned. As a Physician Advisor, the physician provides expertise in utilization management, inpatient medical-necessity determinations, level-of-care review, payer appeals, peer-to-peer discussions, and physician education. The position collaborates across the enterprise to improve physician experience, patient flow, resource utilization, documentation, regulatory compliance, and operational performance. The position maintains a limited clinical practice consistent with organizational needs and the physician's specialty and participates in clinical activities as assigned. This is a full-time, onsite position in Morrisville, North Carolina, with 40 standard hours per week and a day schedule. The stated hiring salary range is $114.71–$329.79 per hour.

Requirements

Graduate of an accredited School of Medicine.
Board certified or board eligible physician licensed in North Carolina.
At least five years of inpatient medical informatics experience.
At least two years of experience as a Physician Advisor.
Significant clinical experience in an inpatient or hospital environment.
Demonstrated physician leadership experience.
Experience with Epic and other digital health platforms, clinical informatics, utilization management, and physician advisory services.
Strong understanding of clinical workflows and physician practice.
Excellent communication, relationship-building, strategic thinking, and change-management skills.

Responsibilities

Serve as a trusted physician leader and strategic partner to enterprise, medical staff, clinical operations, and technology leadership.
Champion physician-centered design for clinical informatics initiatives and optimization of Epic and other digital health tools and platforms.
Establish and advance strategic priorities for digital health workflows in partnership with clinical, operational, and information technology leadership.
Provide physician leadership for major digital health implementations, upgrades, optimization initiatives, and go-live activities.
Serve as a senior physician resource for complex digital health workflow issues, troubleshooting, and resolution.
Partner with IT leadership and vendor representatives to translate clinical needs into effective, scalable, physician-centered solutions.
Lead physician engagement, education, and adoption of optimized digital health workflows, particularly inpatient workflows.
Provide strategic oversight of Epic-enabled utilization-management workflows, including patient status, documentation, and medical necessity.
Identify opportunities to use technology, clinical decision support, and workflow redesign to improve quality, efficiency, patient flow, and physician experience.
Represent physician and clinical priorities in enterprise informatics governance and strategic initiatives.
Lead or support enterprise clinical informatics and performance-improvement initiatives as assigned.
Perform inpatient medical-necessity and level-of-care reviews, peer-to-peer discussions, and clinical appeals.
Provide clinical consultation to physicians and utilization-management teams on complex patient-status and medical-necessity issues.
Educate physicians and clinical teams about utilization management, medical necessity, patient status, and documentation.
Partner with clinical and operational leaders to address systemic utilization-management issues and develop sustainable solutions related to medical informatics needs.
Maintain a limited clinical practice consistent with organizational needs and the physician's specialty.
Participate in clinical activities and responsibilities as assigned.