Job Description Position Summary Responsible for medical staff leadership to the Utilization Management Committee (UMC) and the Case Management (CM) and Health Information Management (HIM)/Clinical Documentation Improvement Departments. Leads and promotes processes for patients to receive medically necessary and high quality care throughout the continuum of care. Stays abreast of professional best practices and community standards of care. Assists Administration in reducing financial risks associated with denials that are due to providing medically unnecessary or preventable services and extended length of stays. Responsibilities Provide and document ongoing education and in-service instruction programs for Hospital's nursing and ancillary personnel related to the Program and focus on coding, compliance, utilization management and quality issues. Conduct and document reviews to determine medical necessity and level of care issues when patients do not meet Interqual criteria and for cost and LOS outliers as referred by the non-physician reviewers. Provide consultation for the Risk Manager and liaison with physicians in matters of reportable events, eg Code 15s and disclosure of unanticipated outcomes in compliance with JCAHO standards and the patient safety policy and in relation to conflicts about end of life issues. Make recommendations to Hospital's administration regarding the use of Hospital personnel, any necessary equipment, and general quality standards of patient care. Develop and document ongoing medical education and in-service instruction programs for Hospital's medical staff relating to issues identified by the Program and focus on coding, compliance, utilization management, quality and patient safety issues and recommend changes to Hospital's policies and procedures. Attend and be a liaison to appropriate Medical Staff Committees relevant to the Program to provide input and guidance to ensure appropriate actions are taken when necessary to mediate conflicts when they arise (for example: Medical Executive Committee, PIM Committee and Patient Safety Committee and Medical Staff Peer Review Committees.).

Qualifications Minimum Requirements Education:

Doctor of Medicine Degree (M.D.) or Doctor of Osteopathic Medicine Degree (D.O.).

Experience:

2 years in a physician leadership role. Prefer Utilization Management and hospital committee chair. Prefer demonstrated ability to work in a collegial role with members of the medical staff and to engage in education to hospital medical staff.

Licensure/Certifications:

Current State MD or DO License and an ABMS (American Board of Medical Specialties) Certification.

Preferred Requirements Education:

Advanced degree in Business and/or Health Care Administration #LI- About Us Embark on a rewarding career with Abrazo West Campus hospital. If you are a compassionate healthcare professional eager to contribute to patient care, this is your opportunity where your skills make a difference every day. Join us in delivering exceptional healthcare with a personal touch. At Abrazo West Campus, we understand that our greatest asset is our dedicated team of professionals. That's why we offer more than a job - we provide a comprehensive benefit package that prioritizes your health, professional development, and work-life balance. The available plans and programs include: Medical, dental, vision, and life insurance 401(k) retirement savings plan with employer match Generous paid time off Career development and continuing education opportunities Health savings accounts, healthcare & dependent flexible spending accounts Employee Assistance program, Employee discount program Voluntary benefits include pet insurance, legal insurance, accident and critical illness insurance, long term care, elder & childcare, auto & home insurance

Note :

Eligibility for benefits may vary by location and is determined by employment status About the Team Abrazo West Campus is recognized for providing exceptional, comprehensive care to patients in West Valley communities. The 200-bed acute care hospital offers advanced services, including the da Vinci Xi surgical platform, Level I Trauma Center, Loop-X system, orthopedics, obstetrics and cardiovascular care.