Senior Director Physician Utilization Management-SWHR CIN
Education
M.D. or D.O. required
Master's Degree Healthcare Administration, Public Health or Business Administration preferred
Experience
5 years general medical clinic practicing physician required and
2 years utilization management experience including MA 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.
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.