Medical Director Utilization Management

The purpose of Dignity Health Management Services Organization (Dignity Health MSO) is to build a system-wide integrated physician-centric, full-service management service organization structure. We offer a menu of management and business services that will leverage economies of scale across provider types and geographies and will lead the effort to develop Dignity Health’s Medicaid population health care management pathways. Dignity Health MSO is dedicated to providing quality managed care administrative and clinical services to medical groups, hospitals, health plans, and employers with a business objective to excel in coordinating patient care in a manner that supports containing costs while continually improving quality of care and levels of service. Dignity Health MSO accomplishes this by capitalizing on industry-leading technology and integrated administrative systems powered by local human resources that put patient care first.

Dignity Health MSO offers an outstanding Total Rewards package that integrates competitive pay with a state-of-the-art, flexible Health & Welfare benefits package. Our cafeteria-style benefit program gives employees the ability to choose the benefits they want from a variety of options, including medical, dental, and vision plans, for the employee and their dependents, Health Spending Account (HSA), Life Insurance, and Long Term Disability. We also offer a 401k retirement plan with a generous employer match. Other benefits include Paid Time Off and Sick Leave.

The Medical Director is responsible for providing clinical expertise and business direction in support of medical management programs to promote the delivery of high quality, constituent responsive medical care. Provides technical expertise in medical management by direct decision making in the areas of:  preauthorization, concurrent review of hospitalized patients, discharge planning, complex case and chronic care management.  This position is responsible for all UM and QM activities including, but not limited to developing clinical guidelines, measuring adherence to guidelines, and communicating utilization and quality concerns on specific cases to the provider network. 

Minimum

• Licensed Physician in the State of California
• Must have three (3) to five (5) years of experience as a Medical Director for HMO/Managed Care
• Five (5) years of clinical practice experience
• Board Certification through American Board of Medical Specialists
• Current State Medical License without restrictions

Preferred

• Board Certified in Internal Medicine or Family Practice Preferred

• Additional competence in geriatrics or special needs populations is desirable

• An advanced degree in business or public health is desirable

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related terms: UM, QM, quality, utilization review, ur