Physician Leader – Utilization & Care Progression

City of Hope; Duarte (CA); On-site; USD 250,000 - 350,000; Full time

Job summary

City of Hope seeks a Medical Director, Physician Advisor to advance utilization management, care progression, and documentation quality within a leading oncology and transplant network in California.

The role leads enterprise reviews, collaborates with Case Management, CDI, and Revenue Cycle, and helps shape physician engagement, education, and policy updates to improve length of stay and denials prevention.

Qualifications

• MD required with active medical staff membership.
• California MD/DO license required.
• Experience in utilization management and regulatory compliance.
• Strong communication and leadership skills.
• Familiarity with InterQual and payer contracts.

Responsibilities

• Lead care progression and discharge planning.
• Conduct utilization reviews incl. complex admissions.
• Co-chair Utilization Review Committee and drive improvements.
• Educate physicians and staff on payer requirements and documentation.

Skills

Utilization management

Leadership

Communication

Interpersonal skills

project coordination

Education

MD/DO (Medical Doctor)

MBA (preferred)

Tools

InterQual by Optum

Microsoft Office

EHR systems

Job description

City of Hope seeks a Medical Director, Physician Advisor to advance utilization management, care progression, and documentation quality within a leading oncology and transplant network in California.

The role leads enterprise reviews, collaborates with Case Management, CDI, and Revenue Cycle, and helps shape physician engagement, education, and policy updates to improve length of stay and denials prevention.