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Medical Director - Utilization Review

Company: Peace Health
Location: Bellingham
Posted on: July 16, 2020

Job Description:

Co-Chair the Utilization Management Committee ans serve as second level reviewer for UM, providing guidance on appropriate/alternative levels of care based on InterQual guidelines and other appropriate criteria. conduct clinical reviews on cases referred by care management staff to meet regulatory requirements and in accordance with the hospitals’ objectives for assuring quality patient care and effective, efficient utilization of health care services. meet with care management and health care team members to discuss selected cases and make recommendations for care, interacting with medical staff members and medical directors of third-party payers to discuss the needs of patients and alternative levels of care. act as consultant to and resource for attending physicians regarding their decisions relative to appropriateness of hospitalization, continued stay, and use of resources. foster effective working relationships among the parties and facilitate resolution to problems. May conduct periodic team meetings with physicians, nurses, support staff and applicable hospital personnel, and implement such other communication methods as are necessary. perform additional job functions as deemed appropriate and warranted. Qualifications Graduate from an accredited school of medicine. Licensure as a physician in Washington state. Federal DEA number. Experience and success in leading and facilitating groups of physicians. Two years utilization management experience as a member of the UM Committee or past physician advisor experience preferred.

Keywords: Peace Health, Bellingham , Medical Director - Utilization Review, Other , Bellingham, Washington

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