Medical Affairs Director – Health Systems Oncology
MSD
Medical Director / Physician Advisor – UM
AdventHealth
full-time
Posted on:
Location: Florida • 🇺🇸 United States
Visit company websiteJob Level
Lead
Tech Stack
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About the role
- · Provides primary support for Utilization Management (UM) and secondary support for Care Management (CM) departments and serves as a liaison between UM and CM teams and medical staff, as well as, the medical liaison for payor escalations. · Responsible for educating, informing and advising members of UM, CM, Managed Care and Revenue Cycle departments and applicable medical staff, collaborating with other disciplines to improve clinical documentation, patient safety, and quality outcomes. · Provides clinical review of utilization, claims management, and quality assurance related to inpatient care, outpatient care/observation stays and referral services. · Acts as important contact for clinicians, external providers, contracted health insurance payors, and regulatory agencies; subject matter expert providing clinical expertise and business direction in support of medical management programs.
Requirements
- · Graduate of accredited Medical School · Bachelor of Science · Minimum of 5 years of experience in hospital medicine in acute care setting · Current and valid license as a physician · Board certified and eligible for membership on the Hospital medical staff
