Senior Director Physician Utilization Management-Southwestern Health Resources

Education
M.D. or D.O. required
Master's Degree in Healthcare Administration, Public Health or Business Administration preferred

Experience
5 years general medical clinic practicing physician and 2 years utilization management experience including Medicare Advantage medical review, peer to peer, and physician/ facility liaison functions required.

Licenses and Certifications
MD - Medical Doctor State of Texas or DO - Doctor of Osteopathic Medicine State of Texas required upon hire. Or, the ability to obtain Texas Medical license within 6 months of hire is required.
American Board of Medical Specialty Certification in respective area required upon hire

Skills
Strong analytical and organizational skills. 
Knowledge of specific regulatory and managed care requirements.
Knowledge of Medicare, Medicaid, and Commercial Coverage Criteria.