Job Description:

Essential Functions

• Reviews physician review operation and provides high-level consultation, review and medical direction. 
• Provides medical consultation in the development and implementation of operational policies and procedures for the accurate and appropriate administration of contracted benefits.
• Reviews and approves all medical changes and options for all products and/or health benefits.
• Coordinates with the credentialing process including developing standards, evaluating provider credentials, advising others and resolving issues with credentialed and non-credentialed providers. 
• Works with others across the organization on the paneling and contracting process to ensure appropriate outcomes.
• Participates in corporate strategic planning with other leaders across the organization and helps facilitate seamless integration by maintaining effective cross-divisional and cross-functional decision-making processes and relationships.
• Works closely and collaboratively with other departments to optimize operational success.
• Coordinates with the Medical Technology review process.
• Willingness to perform physician reviews in addition to oversee medical reviewers to ensure completeness, timeliness and accuracy.

Skills

• Leadership
• Communication
• Taking Initiative
• Performance management
• Process Improvements
• Teamwork
• Workflow optimization
• Process documentation
• Health plan operation
• Federal, state and local regulations
• Computer Literacy

Additional Information

• FTE: 0.2 / 8 hours per week
• Rate: $159.78 to $181.48 per hour based on relevant experience
• Eligible for an annual leadership incentive opportunity based on system goals
• In addition to the annual salary, to show our commitment to you and assist with your transition, we may offer a sign-on and relocation bonus when applicable.

Minimum Qualifications

• Medical Doctor or Doctor of Osteopathic Medicine degree with Board Certification in one of the following areas: Internal Medicine, Pediatrics, Family Practice, Psychiatry or Emergency Medicine.
• Requires current MD or DO licensure within the State of Utah, Idaho, Nevada or Colorado
• Five years of experience in clinical practice.

Preferred Qualifications

• Previous management experience.
• Experience with financial and medical expense management.
• Knowledge of managed care products and processes as well as the impact of managed care on the market and cost of health care
• Understanding of health care delivery system as it relates to government programs and agencies.
• Excellent communication skills including ability to establish and maintain rapport with coworkers, providers, brokers, employers, plan members, representatives/executives from other health care entities, government and regulatory bodies and others in the community.

Physical Requirements

• Ongoing need for employees to see and read information, documents, monitors, identify equipment and supplies, and be able to assess member, provider, and coworkers' needs.
• Frequent interactions with colleagues and providers require employees to verbally communicate as well as hear and understand spoken information, needs, and issues quickly and accurately.
• Frequent computer use for typing, accessing needed information, etc.

Location:

Work City:

Work State:

Scheduled Weekly Hours:

The hourly range for this position is listed below. Actual hourly rate dependent upon experience. 

We care about your well-being – mind, body, and spirit – which is why we provide our caregivers a generous benefits package that covers a wide range of programs to foster a sustainable culture of wellness that encompasses living healthy, happy, secure, connected, and engaged.

Learn more about our comprehensive benefits package here.

By applying for a position with Intermountain, I acknowledge that I will comply with all applicable Intermountain policies and expectations. If applying for a remote or hybrid role, this includes remote work expectations related to confidentiality, information security, work schedules, conflicts of interest, and use of company equipment. I further acknowledge that outside employment or activities may not interfere with job responsibilities or create a conflict of interest with Intermountain. Actual or reasonably perceived conflicts may be grounds for disqualification from consideration or, if hired, corrective action up to and including termination of employment.

Intermountain Health is an equal opportunity employer. Qualified applicants will receive consideration for employment without regard to race, color, religion, age, sex, sexual orientation, gender identity, national origin, disability or protected veteran status.

At Intermountain Health, we use the artificial intelligence ("AI") platform, HiredScore to improve your job application experience. HiredScore helps match your skills and experiences to the best jobs for you. While HiredScore assists in reviewing applications, all final decisions are made by Intermountain personnel to ensure fairness. We protect your privacy and follow strict data protection rules. Your information is safe and used only for recruitment. Thank you for considering a career with us and experiencing our AI-enhanced recruitment process.

All positions subject to close without notice.