Medical Director, Utilization Management- CFHP

University Health

$210K — $250K *
Healthcare
5 - 7 years of experience
Job Overview by Ladders

Qualifications

  • MD or DO with an active Texas Medical License
  • Minimum 5 years of direct clinical patient care experience
  • Preferred 2 years in a medical leadership role
  • Experience in managed care leadership preferred
  • Knowledge of utilization review and quality management procedures

Responsibilities

  • Provide clinical leadership for population health management program
  • Oversee utilization and case management initiatives
  • Drive preventive health and disease management efforts
  • Ensure quality management standards are met
  • Collaborate with multidisciplinary teams for integrated service delivery

Benefits

  • Professional development opportunities
  • Supportive work environment
  • Contribution to healthcare quality improvement
  • Engagement with a diverse team
  • Opportunity to impact member health outcomes
Full Job Description
POSITION SUMMARY/RESPONSIBILITIES

This position provides clinical leadership and oversight of the population health management program including utilization management, case management, preventive health/disease management, and quality management while supporting the multidisciplinary member-centric approach to care management. Actively participates with staff across the organization - this is essential to facilitate integrated service delivery, planning, quality assurance, and risk management and to address the needs of members and their families to protect and promote the healthcare of members.
EDUCATION/EXPERIENCE

A medical degree as Doctor of Medicine (MD) or Osteopathy (DO) and an active and unrestricted Texas Medical License, free of sanctions from Medicaid or Medicare is required. Minimum of five year of direct clinical patient care experience post-residency is required. Minimum two years' experience in a medical leadership role is preferred. Previous experience in a leadership position in managed care is preferred, with knowledge and understanding of utilization review and quality management procedures.

LICENSURE/CERTIFICATION

Current unrestricted license as a Doctor of Medicine or Osteopathy for Texas is required. Board certification is required.

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