Director Utilization Mgmt at Wellpath

Cleveland, Ohio, United States -

Full Time

Start Date

Immediate

Expiry Date

20 Mar, 26

Salary

0.0

Posted On

20 Dec, 25

Experience

2 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Utilization Management, Case Management, Quality Improvement, Communication, Organizational Skills, Policy Improvement, Data Research, Patient Care, Employee Development, Coaching, Counseling, Retention, Performance Reviews, Collaboration, Clinical Resources, Compassion

Industry

Hospitals and Health Care

Description

Why Wellpath Now is your moment to make a difference in the lives of the underserved. If there is one unifying characteristic of everyone on our team, it is the deep desire to make a difference by helping society's most vulnerable and often overlooked individuals. Every day we have the distinct honor and responsibility to show up with non-judgmental compassion to provide hope and healing to those who need it most. For those whose calling it is to serve others, now is your moment to join our mission to provide quality care to every patient with compassion, collaboration, and innovation, to live our mantra to “Always Do The Right Thing!”, and to collectively do our part to heal the world, one patient at a time. Wellpath sees hundreds of thousands of unique individuals in their facilities month over month and a very large percent of those individuals receive direct clinical care, which includes lives saved by Narcan. We offer ongoing training and development opportunities for licensed and unlicensed healthcare team members, and have best in class clinical resources for training, education, and point of care support. About this role The Medical Director of Utilization Management leads and oversees utilization review, case management, quality improvement, and related policy and practice initiatives within their assigned area. They provide guidance and direction to medical staff in their efforts to ensure quality patient care and the appropriate utilization of medical services. The Medical Director of Utilization Management serves as a key liaison with external partners and stakeholders, and works collaboratively with internal teams to optimize care delivery and achieve operational goals. Additional Details This is on onsite role based in Lemoyne, Pennsylvania at our Regional Office. PA DOC Regional Office 600 N. 12th Street, Ste #1 Lemoyne, Pennsylvania 17043 RELOCATION ASSISTANCE. What you bring to the table Education Medical Doctor (M.D.) or Osteopathic Doctor (D.O.) from an accredited university Experience One (1) year of experience in utilization management is required. Excellent communication and organizational skills required. Experience in Performance and/or Quality Improvement preferred. Licenses/Certifications Current license in state of employment to practice medicine What you will do Ensure the use of nationally recognized criteria and evidence-based standards for inpatient concurrent reviews and offsite service requests. Manage UM staff including performance reviews, employee development, hiring, coaching, counseling, and retention. Lead UM process improvements, facilitate patient care goals, and utilize data research to reduce length of inpatient stays and decrease ED admissions. Evaluate and recommend policy improvement related to utilization review system, and provide UM updates and participate in meetings. Establish and monitor progress towards UM program goals, maintain offsite service and UM tracking/reporting, and facilitate regular meetings with partner hospital clinical regarding offsite services. We are an Equal Employment Opportunity Employer We are committed to fostering, cultivating, and preserving a culture of uniqueness. We celebrate a variety of backgrounds and are committed to creating an inclusive environment for all employees. We encourage you to apply! If you are excited about a role but your experience doesn’t seem to align perfectly with every element of the job description, we encourage you to apply. You may be just the right candidate for this, or one of our many other roles. Deadline to apply to this position is contingent upon applicant volume. Those positions located in Colorado will have a specific deadline posted in the job description. We are an Affirmative Action Employer in accordance with applicable state and local laws. We are an Equal Employment Opportunity Employer We are committed to fostering, cultivating, and preserving a culture of uniqueness. We celebrate a variety of backgrounds and are committed to creating an inclusive environment for all employees. We encourage you to apply! If you are excited about a role but your experience doesn’t seem to align perfectly with every element of the job description, we encourage you to apply. You may be just the right candidate for this, or one of our many other roles. Deadline to apply to this position is contingent upon applicant volume. Those positions located in Colorado will have a specific deadline posted in the job description. We are an Affirmative Action Employer in accordance with applicable state and local laws.

Responsibilities

The Medical Director of Utilization Management leads and oversees utilization review, case management, and quality improvement initiatives. They provide guidance to medical staff to ensure quality patient care and appropriate utilization of medical services.