Family Medicine Hospital Based job located in North Carolina

Seeking a Medical Director of Utilization Management
--Full Time: 40 hrs/wk
--Mon-Fri 8A-5P
--Serve as the clinical expert on physician practice patterns, over- and under-utilization of resources, medical necessity, levels of care, care progression, denial management, compliance with governmental and private payer regulations, appropriate physician coding, and documentation requirements.
--Work closely with medical staff leadership, all medical staff, and ancillary departments to optimize services and ensure appropriateness of patient care.
--Collaborate with hospital leadership to develop care management protocols that drive improvements and effectively manage resources.
--Guaranteed base salary
--Health, life, and disability coverage
--3 retirement savings plans – 401a, 403b with match, 457b
--Paid time off benefits
--CME allowance, license, and DEA reimbursement
--Customized wellbeing resources
--Free fitness center membership
--Paid Parental Leave
--Paid malpractice with tail coverage
--Required: Current CHCQM-PHYADV certification, or ability to obtain within 90 days of employment, Board Certification, Active, unrestricted NC medical license.
--5+ years of post-residency clinical practice experience PLUS at least one year of prior UM experience.
--Thorough understanding of current CMS and DNV compliance requirements
--Robust knowledge of hospital coding and billing, payer contracting, and revenue cycle management.
--Effective collaboration with physician peers, administration, and support staff.
--Advanced proficiency with EMRs and utilization review tools.

Job ID 2668