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Optum: Utilization Management Medical Director


This is a Part-time position in Seatac, WA posted January 21, 2021.

Utilization Management Medical Director You already love the Northwest!

Why not love your career, too?

The Everett Clinic is looking for a full-time or part-time, physician to improve patient care outcomes and quality metrics through completion of utilization management functions for value-based patients in the Washington region.

Join our supportive and collegial team who enjoy work/ life harmony while providing high quality care.

Job Summary: Through chart and claim reviews help identify affordability initiatives by critical review of trends seen in performing UM functions.

Works with Regional Medical Director or VP of Medical Management to support affordability and total cost of care initiatives, including:Chart auditsClaims reviewsRetrospective reviewsHelp identify Affordability initiatives by critical review of trends seen in perfuming UM functions.Supports the functions of Population Health’s Utilization Management (UM)/Complex Case Management (CCM) operations and services, This requires reviews and responses be done in regulated timeframe to meet regulatory guidelines.Support organizations payer meetings as needed including audits and JOCs.Participate in ongoing reviews of policies and procedures, metrics, protocols, guidelines and tools to improve the utilization management program.Proactively identify quality and process improvement opportunities and collaborate with care team and leaders.

The TEC Experience Highly competitive compensation and benefitsWork life balance with flexible shiftsFull-time and Part-time options availablePotential remote work accommodationCME allowanceShape the future of healthcare to a value based care model If you value quality, goabove-and-beyond in making patients a priority and want to help cultivate a fun, team centered environment, we want to talk to you.

Contact: Markus Smith, Provider Recruitment ■ 425-339-5475 ■ masmith@everettclinic.com

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