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Medical Director

2 months ago

Prescott, Arizona, United States Dignity Health Full time
About the Role

We are seeking a highly skilled Physician Advisor to join our team at Dignity Health. As a key member of our clinical leadership team, you will play a critical role in promoting evidence-based standards of medical care while maintaining appropriate utilization of hospital resources.

Key Responsibilities
  • Utilization Management: Provide valid and effective secondary medical necessity reviews to mitigate denials for payment from insurance payers.
  • Compliance: Ensure compliance with Centers for Medicare and Medicaid Services (CMS) Conditions of Participation by performing secondary medical necessity reviews.
  • Clinical Leadership: Champion good stewardship of resources and optimize revenue capture by providing oversight for appropriate status determinations.
  • Care Coordination: Serve as a resource for Care Coordination by determining the appropriateness of referrals, applying professional judgment in the context of patient-related variables, and consulting with attending physicians, residents, and other health professionals as needed.
Requirements
  • Education: Doctor of Medicine (MD or DO) degree.
  • Experience: Minimum of five years clinical practice experience.
  • Licensure: Licensed to practice medicine without restrictions in the State where performing Physician Advisor duties.
  • Skills: Strong clinical judgment and technical abilities, strong collaboration skills with other physicians, excellent interpersonal and communication skills.
What We Offer
  • Competitive Compensation: $123.07/hour.
  • Benefits: Medical/Dental/Vision Insurance, Flexible spending accounts, Matching 403(b) retirement program, Fully Funded Pension Plan, Paid Time Off (PTO), Tuition Reimbursement, Mental Health Benefit, Employee Life Insurance.