Summary
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.
Occasionally
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)
(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