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VP / Medical Director of Utilization Management at Somatus in Dhs, VA



$100K — $150K *



Medicine, Healthcare Management


Less than 5 years

Job Description


The VP/Medical Director of Utilization Management is responsible for helping to manage member medical costs and assuring appropriate health care delivery for the assigned health plan members. Reports organizationally to the Senior Vice President of Medical Affairs. Supports design and implementation of medical policies, and appropriate Utilization Management goals and objectives. Interfaces with the provider community regarding full-scope Utilization Management and evidence-based medicine. Provides professional leadership and direction to the functions within the Somatus Office of Medical Affairs. Under SVP leadership, is responsible and accountable for executing the Utilization Management Program and relevant Clinical Quality Improvement Programs in partnership with the Market Medical Directors.


Provides critical thinking for analysis, evaluation and modification of data (e.g., medical, pharmacy, quality)

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Valid through: 7/17/2020

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