Medical Director Physician Advisor - Utilization Management Informatics

UNC Health; Morrisville (NC); On-site; USD 158,000 - 454,000; Full time

Job summary

UNC Health is seeking a Medical Director of Utilization Management Informatics to lead system-wide digital health initiatives, with emphasis on Epic workflows and inpatient implementations. This role partners with clinical operations, IT, and enterprise leadership to align clinical needs with technology and documentation practices.

The physician advisor will guide medical-necessity reviews, payer communications, and educational efforts across enterprise departments while ensuring efficient

Qualifications

• Graduate of an accredited School of Medicine.
• Board certified/eligible in North Carolina.
• At least five years in inpatient medical informatics.
• Two years as a Physician Advisor.

Responsibilities

• Serve as trusted physician leader and strategic partner to enterprise, medical staff, clinical operations, and technology leadership.
• Lead Epic-enabled utilization-management workflows and engage in physician education.
• Provide clinical consultation on complex patient-status and medical-necessity issues.
• Maintain a limited clinical practice aligned with organizational needs.

Skills

Epic experience

Utilization management

Physician leadership

Clinical informatics

Education

Medical degree

North Carolina license

Tools

Epic

Job description

Description

Your passion belongs at UNC Health. Join more than 56,000 teammates working together to improve the health and well-being of the communities we serve across North Carolina.

Summary

TheHCS Medical Dir Utilization Management Informatics is an enterprisephysician leadership role responsible for advancing the effective use ofclinical information technology and supporting high-quality, efficient, andclinically appropriate care. This position will provide strategic and operational leadership for system-wideimplementation and optimization initiatives for multiple digital health toolsand platforms, including Epic, with a focus on support for the Eastern andCoastal regions and on inpatient digital health implementation, go-live support,physician engagement, workflow improvement, and clinical informaticsinitiatives. The Medical Director will serve as a key physicianliaison among medical staff, clinical operations, information technology, andenterprise leadership

The position will alsoprovide physician leadership for the integration of utilization-managementprocesses into Epic workflows, helping ensure that technology,clinical workflows, documentation, and utilization-management practices arealigned. As a Physician Advisor,the physician will provide clinical expertise in utilizationmanagement, inpatient medical-necessity determinations, level-of-care review,payer appeals, peer-to-peer discussions, and physician education. The position will collaborate across theenterprise to improve physician experience, patient flow, appropriate resourceutilization, documentation, regulatory compliance, and operational performance.

Responsibilities

Associate Chief Medical Informatics Officer: Serve as a trusted physician leader and strategic partner to enterprise, medical staff, clinical operations, and technology leadership. Champion physician-centered design for clinical informatics initiatives and optimization of Epic and other digital health tools and platforms. Establish and advance strategic priorities for digital health workflows in partnership with clinical, operational, and information technology leadership. Provide physician leadership for major digital health implementations, upgrades, optimization initiatives, and go-live activities. Serve as a senior physician resource for complex digital health workflow issues, troubleshooting, and resolution. Partner with IT leadership and appropriate vendor representatives to translate clinical needs into effective, scalable, and physician-centered solutions. Lead physician engagement, education, and adoption of optimized digital health workflows, with a focus on inpatient workflows. Provide strategic oversight of Epic-enabled utilization-management workflows, including patient status, documentation, medical necessity, and related processes. Identify opportunities to leverage technology, clinical decision support, and workflow redesign to improve quality, efficiency, patient flow, and physician experience. Represent physician and clinical priorities in enterprise informatics governance and strategic initiatives. Lead or support enterprise clinical informatics and performance-improvement initiatives as assigned.

Physician Advisor: Perform inpatient medical-necessity, level-of-care reviews, peer-to-peer discussions, and clinical appeals. Provide clinical consultation to physicians and utilization-management teams regarding complex patient-status and medical-necessity issues. Educate physicians and clinical teams regarding utilization management, medical necessity, patient status, and documentation. Partner with clinical and operational leaders to address systemic utilization-management issues and develop sustainable solutions related to medical informatics needs.

Clinical Practice: Maintain a limited clinical practice consistent with organizational needs and the physician's specialty. Participate in clinical activities and responsibilities as assigned.

Other Information

Education Requirements

• Graduate of an accredited School of Medicine.

Licensure/Certification Requirements

• Board certified/eligible physician licensed in the state of North Carolina.

Professional Experience Requirements

• Requires at least five (5) years of inpatient medical informatics experience and two (2) years as a Physician Advisor.

Knowledge/Skills/and Abilities Requirements

• Significant clinical experience in an inpatient/hospital environment.


• Demonstrated physician leadership experience.


• Experience with Epic and other digital health platforms, clinical informatics, utilization management, and physician advisory services.


• Strong understanding of clinical workflows and physician practice.


• Excellent communication, relationship-building, strategic thinking, and change-management skills.

Job Details

Legal Employer: NCHEALTH

Entity: Shared Services

Organization Unit: System UM Leadership and PA

Work Type: Full Time

Standard Hours Per Week: 40.00

Salary Range:$114.71 - $329.79 per hour (Hiring Range)

Pay offers are determined by experience and internal equity

Work Assignment Type: Onsite

Work Schedule: Day Job

Location of Job: US:NC:Morrisville

Exempt From Overtime: Exempt: Yes

This position is employed by NC Health (Rex Healthcare, Inc., d/b/a NC Health), a private, fully-owned subsidiary of UNC Health Care System, in a department that provides shared services to operations across UNC Health Care; except that, if you are currently a UNCHCS State employee already working in a designated shared services department, you may remain a UNCHCS State employee if selected for this job.

Qualified applicants will be considered without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, genetic information, disability, status as a protected veteran or political affiliation.

UNC Health makes reasonable accommodations for applicants' and employees' religious practices and beliefs, as well as applicants and employees with disabilities. All interested applicants are invited to apply for career opportunities. Please email [e-mail] if you need a reasonable accommodation to search and/or to apply for a career opportunity.