Physician Advisor, Utilization Management: Join Lexington Medical Center in Columbia, SC (Onsite)
Company: Lexington Medical Center
Location: West Columbia
Posted on: October 19, 2024
Job Description:
Join as our Physician Advisor & Medical Director of Utilization
Management to join our dynamic healthcare organization to help
shape the future of healthcare delivery through effective resource
utilization, exceptional patient care, and evidence-based
practices. As the Medical Director of Utilization Management, you
will play a vital role in ensuring effective and efficient
utilization of hospital resources while maintaining high-quality
medical care. This includes evaluation and development of processes
and protocols to optimize length of hospital stay and efficient
management of resources, championing best practices, ensuring
patients are at the appropriate level of care, supporting
documentation improvement initiatives, preventing payer denials,
and promoting compliance with state and federal regulations. This
is an excellent opportunity for a motivated and experienced
individual with a strong clinical background and a passion for
process improvement. Position Highlights:
- Split schedule: 80% Administrative; 20% Hospitalist coverage
- Hospitalist experience required
- Responsible for the quality, effectiveness, and efficiency of
utilization management processes inclusive of:
- Concurrent and retrospective medical necessity reviews
- Oversight and education related to level of care management,
length of stay management, and utilization of ancillary
services
- Analyze utilization patterns and recommend changes in hospital
policies, procedures or practices as indicated by findings
- Monitor and ensure compliance with internal policies and
applicable standards and regulations.
- Coordinate organizational efforts to reduce inappropriate
admissions and readmissions
- Collaborate with medical staff and leadership to support
clinical documentation improvement efforts
- Conduct Peer to peer reviews with payers to mitigate
denials
- Identify denial trends and work with the medical staff and
hospital administration to implement processes to mitigate
these.
- Participate in medical staff meetings to champion utilization
management initiatives
- Chair of Utilization Management Committee We are committed to
offering quality, cost-effective benefits for our employees and
their families. Competitive Day ONE Benefits:
- Medical, Dental, and Vision Insurance
- Retirement and Savings Plans with No Vesting Period
- 24/7 Live Epic EMR Support from Our On-site Team
- Relocation Assistance and Sign On Bonus Opportunities
- Annual CME Allowance
- Medical Malpractice Coverage
- Life, Accidental, and Critical Illness Insurance
- Employer Paid Short- and Long-Term Disability (after 90
days)
- Healthcare FSA
- Daycare FSA
- 529 College Savings Plans
- Adoption Assistance
- Dependent Life Insurance
- On-site Child Care Center
- Public Service Loan Forgiveness (PSLF) Employer
- Health Directions Gym Membership
- Employee Discounts and Services Lexington Medical Center is a
607-bed teaching hospital in West Columbia, South Carolina. It
anchors a health care network that includes six community medical
centers and employs a staff of more than 8,500 health care
professionals. The hospital is ranked best hospital in the Columbia
Metro and hospital in South Carolina by U.S. News & World Report
and was named one of the "Best Places to Work in South Carolina" by
SC Biz News, in partnership with the South Carolina Chamber of
Commerce and Best Companies Group. Lexington Medical Cancer Center
is an accredited Cancer Center of Excellence and has a clinical
research and education affiliation with MUSC Hollings Cancer
Center. The network includes a cardiovascular program recognized by
the American College of Cardiology as South Carolina's first
HeartCARE Center. The network also has an occupational health
center, the largest skilled nursing facility in the Carolinas, an
Alzheimer's care center and more than 70 physician practices.
Lexington Medical Center operates one of the busiest Emergency
departments in South Carolina, treating nearly 100,000 patients
each year. The hospital delivers more than 4,000 babies each year
and performs more than 25,000 surgeries. Its postgraduate medical
education programs include family medicine and transitional year
residencies. We've been named Columbia's "Best Place to Have a
Baby," "Best Hospital" and one of the "Top 25 Best Hospitals to
Work for in the U.S.," honors all made possible by a dedicated,
talented team of health care professionals and staff. Community
Highlights:
- Within Driving Distance to 7 Major Airports
- Close proximity to beautiful Lake Murray
- Safe, family friendly community
- Reasonable Cost of Living
- Central Location, easy access to mountains and beaches
- Located on the banks of the Congaree and Saluda Rivers, outdoor
activities plentiful
- Home to some of the best school Districts in the State Located
in the heart of South Carolina, Columbia offers an unexpected mix
of tradition and tomorrow. Pairing a diverse food & drink scene
with shopping, festivals and family friendly attractions; Columbia
has something for everyone. On the banks of the Congaree River,
Columbia boasts a wide variety of outdoor recreation activities, a
premier international art museum, an award winning children's
museum, a Zoo and Garden plus Division 1 Sports make Columbia,
South Carolina an ideal place to live, work and play. Please visit
our facility websites and to learn more about Lexington Medical
Center.
Keywords: Lexington Medical Center, Rock Hill , Physician Advisor, Utilization Management: Join Lexington Medical Center in Columbia, SC (Onsite), Healthcare , West Columbia, South Carolina
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