Medical Director-Case Management

Samaritan Health Services
Corvallis, Oregon
Full Time

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THIS HYBRID POSITION INVOLVES BOTH REMOTE WORK AND THE ABILITY TO COMMUTE TO ANY OF THE SAMARITAN#HOSPITALS AS NEEDED TO PROVIDE IN-PERSON SUPPORT AND EDUCATION TO CASE MANAGEMENT AND PROVIDERS. # JOB SUMMARY/PURPOSE Has the overall responsibility for providing medical direction, input into policy/ procedure development, participation in performance monitoring including organization-wide quality improvements and promotes and supports educational growth from the staff and community. Provides medical consultation and case review for Case Managers at all Samaritan Hospitals. Acts as a liaison with medical staff and hospital administration regarding discharge and length of stay issues. DEPARTMENT DESCRIPTION The Utilization Management team is a centralized team of physicians, nurses and specialists that perform admission and continued stay compliance reviews for all Samaritan Hospitals. Utilization Management nurses and physicians are specially trained in Medicare and commercial insurance regulations, perform reviews on all admitted patients and provide staff and physician education. The Utilization Management team communicates information to insurance companies to assure payment of hospital services. EXPERIENCE/EDUCATION/QUALIFICATIONS MD or DO degree required. Board Certification in the practice specialty required. Unrestricted license to practice medicine in the State of Oregon required. Five (5) years experience in the practice of medicine with a strong clinical background and familiarity with care of hospitalized patients required. Three (3) years experience in similar areas of accountability preferred. Experience with computer applications, electronic medical records, other medical programs and electronic medical literature required. Experience with hospital Utilization Review, Medicare regulations and health insurance policies preferred. Experience efficiently researching, analyzing and summarizing complex clinical topics preferred. KNOWLEDGE/SKILLS/ABILITIES Leadership - Inspires, motivates, and guides others toward accomplishing goals. Achieves desired results through effective people management. Conflict resolution - Influences others to build consensus and gain cooperation. Proactively resolves conflicts in a positive and constructive manner. Critical thinking # Identifies complex problems. Involves key parties, gathers pertinent data and considers various options in decision making process. Develops, evaluates and implements effective solutions. Communication and team building # Leads effectively with excellent verbal and written communication. Delegates and initiates/manages cross-functional teams and multi-disciplinary projects. PHYSICAL DEMANDS Rarely (1 - 10% of the time) Occasionally (11 - 33% of the time) Frequently (34 - 66% of the time) Continually (67 # 100% of the time) CLIMB - LADDER# LIFT (Floor to Waist: 0#-36#) 20 - 40 Lbs# SQUAT Static (hold #30 sec) STAND# WALK - LEVEL SURFACE# WALK - INCLINE# CLIMB - STAIRS# SQUAT Repetitive# BEND FORWARD at waist# ROTATE TRUNK Standing# PUSH (40-60 pounds force) PULL (40 - 60 pounds force) SIT# ROTATE TRUNK Sitting REACH - Forward# REACH - Upward# MANUAL DEXTERITY Hands/wrists# FINGER DEXTERITY# PINCH Fingers# GRASP Hand/Fist LIFT (Floor to Waist: 0#-36#) 0 - 20 Lbs LIFT (Knee to chest: 24#-54#) 0 - 20 Lbs# LIFT (Waist to Eye: up to 54#) 0 - 20 Lbs# LIFT (Overhead: 54# and above) 0 - 20 Lbs# CARRY 1-handed, 0 - 20 pounds# CARRY 2-handed, 0 - 20 pounds

THIS HYBRID POSITION INVOLVES BOTH REMOTE WORK AND THE ABILITY TO COMMUTE TO ANY OF THE SAMARITAN HOSPITALS AS NEEDED TO PROVIDE IN-PERSON SUPPORT AND EDUCATION TO CASE MANAGEMENT AND PROVIDERS.
JOB SUMMARY/PURPOSE
Has the overall responsibility for providing medical direction, input into policy/ procedure development, participation in performance monitoring including organization-wide quality improvements and promotes and supports educational growth from the staff and community. Provides medical consultation and case review for Case Managers at all Samaritan Hospitals. Acts as a liaison with medical staff and hospital administration regarding discharge and length of stay issues.
DEPARTMENT DESCRIPTION
The Utilization Management team is a centralized team of physicians, nurses and specialists that perform admission and continued stay compliance reviews for all Samaritan Hospitals. Utilization Management nurses and physicians are specially trained in Medicare and commercial insurance regulations, perform reviews on all admitted patients and provide staff and physician education. The Utilization Management team communicates information to insurance companies to assure payment of hospital services.
EXPERIENCE/EDUCATION/QUALIFICATIONS
MD or DO degree required.
Board Certification in the practice specialty required.
Unrestricted license to practice medicine in the State of Oregon required.
Five (5) years experience in the practice of medicine with a strong clinical background and familiarity with care of hospitalized patients required.
Three (3) years experience in similar areas of accountability preferred.
Experience with computer applications, electronic medical records, other medical programs and electronic medical literature required.
Experience with hospital Utilization Review, Medicare regulations and health insurance policies preferred.
Experience efficiently researching, analyzing and summarizing complex clinical topics preferred.
KNOWLEDGE/SKILLS/ABILITIES
Leadership - Inspires, motivates, and guides others toward accomplishing goals. Achieves desired results through effective people management.
Conflict resolution - Influences others to build consensus and gain cooperation. Proactively resolves conflicts in a positive and constructive manner.
Critical thinking - Identifies complex problems. Involves key parties, gathers pertinent data and considers various options in decision making process. Develops, evaluates and implements effective solutions.
Communication and team building - Leads effectively with excellent verbal and written communication. Delegates and initiates/manages cross-functional teams and multi-disciplinary projects.
PHYSICAL DEMANDS
Rarely