Medical Director / Physician Advisor – UM
AdventHealth
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Medical Director – Physician Advisor, Utilization Management
AdventHealth
full-time
Posted on:
Origin: • 🇺🇸 United States • Florida
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)
- Serves as a liaison between UM and CM teams and medical staff and as medical liaison for payor escalations
- Educates, informs and advises Utilization Management, Care Management, Managed Care and Revenue Cycle departments and medical staff
- Collaborates 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/observation stays and referral services
- Acts as contact for clinicians, external providers, contracted health insurance payors, and regulatory agencies
- Serves as subject matter expert providing clinical expertise and business direction for medical management programs to promote high-quality, patient-focused, cost-effective care
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
