Medical Director-Case Management

Samaritan Health Services; Corvallis (OR); Hybrid; USD 180,000 - 240,000; Full time

Job summary

Samaritan Health Services in Corvallis, Oregon seeks an experienced medical leader to provide medical direction across Utilization Management. The role partners with hospital leadership to align policy, quality improvement, and patient care standards, while supporting education for staff and the community.

The successful candidate holds an MD or DO, board certification, and an unrestricted Oregon medical license, with substantial clinical and administrative experience in hospital settings.

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 strong clinical background.
• Three (3) years experience in similar accountability areas preferred.
• Experience with EMR, medical literature, and Medicare regulations preferred.

Responsibilities

• Provide medical direction and input into policy/procedure development.
• Participate in performance monitoring and organization-wide quality improvements.
• Promote educational growth from staff and community.
• Provide medical consultation and case review for Case Managers at Samaritan Hospitals.
• Liaise with medical staff and hospital administration regarding discharge and length of stay issues.

Skills

Leadership

Conflict resolution

Critical thinking

Communication

Education

MD/DO

Board certification

Oregon license

Job description

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

SIT

ROTATE TRUNK Sitting

REACH - Forward

REACH - Upward

MANUAL DEXTERITY Hands/wrists

FINGER DEXTERITY

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