Medical Director Utilization Management

Location:

Work from home (Pennsylvania)

Shift:

Days (United States of America)

Scheduled Weekly Hours:

40

Worker Type:

Regular

Exemption Status:

Yes

Job Summary:

Establishes and leads execution of a strategic plan for the provision of Utilization Management services across the organization, fostering a spirit of innovation in care delivery, maximizing the use of technology where possible to improve quality and enhance efficiency. The Medical Director will direct providers, faculty, residents and other clinicians, to optimize the care of patients and provide effective and meaningful educational programs across the department. Responsible for management of the Utilization Review policy and observation management performance including outcomes of medical necessity justification with health plan medical director staff.

Job Duties:

• Provides leadership, planning, organization, staffing, coordination and evaluation for organizations activities.
• Responsible for the development and maintenance of the capital and operating budgets of the department.
• Work collaboratively with the clinical, administrative and finance leaders to establish appropriate budgets for staffing and delivering all components of the clinical, research and education programs within the department.
• Act as liaison with hospital administration and other hospital platforms to promote innovative care and teaching in clinical departments.
• Supervise and evaluate all institute physicians in clinical and assigned administrative duties.
• Responsible for all quality improvement efforts in the department.
• Directs and oversees the clinical, operational and financial management of the department.
• Responsible for all organizational and accrediting and regulatory agency standards, policies and procedures.

Work is typically performed in a clinical and office environment. Accountable for satisfying all job specific obligations and complying with all organization policies and procedures. The specific statements in this profile are not intended to be all-inclusive. They represent typical elements considered necessary to successfully perform the job. Additional competencies outlined in any department-specific orientation will be considered essential to the performance of the job related to that position.

Position Details:

Education:

Doctor of Medicine or Doctor of Osteopathic Medicine- (Required)

Experience:

Minimum of 10 years-Clinical (Required), Minimum of 5 years-Leadership (Required)

Certification(s) and License(s):

Licensed Medical Doctor – State of Pennsylvania

Skills:

Office Administration

OUR PURPOSE & VALUES: Everything we do is about caring for our patients, our members, our students, our Geisinger family and our communities.

• KINDNESS: We strive to treat everyone as we would hope to be treated ourselves.
• EXCELLENCE: We treasure colleagues who humbly strive for excellence.
• LEARNING: We share our knowledge with the best and brightest to better prepare the caregivers for tomorrow.
• INNOVATION: We constantly seek new and better ways to care for our patients, our members, our community, and the nation.
• SAFETY: We provide a safe environment for our patients and members and the Geisinger family.

We offer healthcare benefits for full time and part time positions from day one, including vision, dental and domestic partners. Perhaps just as important, we encourage an atmosphere of collaboration, cooperation and collegiality.

We know that a diverse workforce with unique experiences and backgrounds makes our team stronger. Our patients, members and community come from a wide variety of backgrounds, and it takes a diverse workforce to make better health easier for all. We are proud to be an affirmative action, equal opportunity employer and all qualified applicants will receive consideration for employment regardless to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or status as a protected veteran.

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