Medical Director Utilization Management

When you join the Huntington Hospital team, you are aligning yourself with an organization whose values drive our philosophy of compassionate community care. Over the past 129 years, we've grown from a small 16-bed hospital to a nationally recognized healthcare leader with 619 beds. As part of our commitment to providing equitable, high-quality care to all members of our community, we embrace differences and work hard to create a place of belonging for our patients and our employees. When you join the Huntington family, you'll be empowered to enact change that continuously improves our ability to deliver world-class care, with kindness and dignity, to all who need it.

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Compensation Range:

Anticipated Base compensation rate is in the range of $0.00 - $0.00 / 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