Director of Utilization & Clinical Quality

Boston Medical Center; Towson (MD); On-site; USD 200,000 - 260,000; Full time

Benefits offered by this job

Health insurance

Retirement plan

Paid time off

Job summary

GBMC Hospital is seeking a Physician Advisor Director to lead a multidisciplinary team in utilization management, clinical quality, and case management. The role includes policy development, denials review, and coordination with care teams to optimize patient care and reimbursement.

The position requires MD-level training, Board certification, and several years in utilization management with strong leadership and education skills. The role is full-time, on-site at GBMC Hospital in Towson, MD.

Qualifications

• MD degree from an accredited medical program.
• Education in utilization and quality management preferred.

Responsibilities

• Provide clinical direction and leadership for PA, CM, UR, Social Work teams.
• Oversee denials review and appeals processes and quality initiatives.
• Collaborate with hospital leaders to ensure adherence to best practices and regulatory standards.
• Support education of medical staff on regulatory requirements and documentation.

Skills

Utilization Mgmt

Clinical Quality

Leadership

Education/Mentoring

Interpersonal Skills

Education

MD degree

Tools

CMS/CDI systems

EHR systems

Job description

GBMC Hospital is seeking a Physician Advisor Director to lead a multidisciplinary team in utilization management, clinical quality, and case management. The role includes policy development, denials review, and coordination with care teams to optimize patient care and reimbursement.

The position requires MD-level training, Board certification, and several years in utilization management with strong leadership and education skills. The role is full-time, on-site at GBMC Hospital in Towson, MD.