Physician Leader, Utilization Management

WVU Medicine; Morgantown (WV); On-site; USD 170,000 - 210,000; Full time

Job summary

SMG System Medical Group in Morgantown, WV is seeking a Physician Advisor for Utilization Management to partner with medical staff leadership and case management to optimize hospital service use and patient care.

You will develop protocols, lead physician education sessions, monitor length of stay, and ensure appropriate levels of care while supporting regulatory compliance and cost efficiency. Travel to system hospitals and quarterly time reporting are expected.

Qualifications

• Doctorate of Medicine from an accredited School of Medicine or Osteopathy.
• Holds or eligible for Medical licensure in the State of West Virginia.
• Minimum 5 years clinical experience in the practice of medicine is preferred.

Responsibilities

• Provides strategic input to planning and resource allocation for Utilization Management.
• Educates physicians and clinicians on regulatory requirements and appropriate utilization of hospital services.
• Identifies and analyzes denial trends; collaborates with staff to resolve issues and improve outcomes.
• Develops and implements utilization management protocols with physicians and hospital leadership.
• Monitors length of stay and resource use to ensure appropriate level of care and documentation.

Skills

Clinical experience

Education

Doctorate of Medicine (MD) or DO

Job description

SMG System Medical Group in Morgantown, WV is seeking a Physician Advisor for Utilization Management to partner with medical staff leadership and case management to optimize hospital service use and patient care.

You will develop protocols, lead physician education sessions, monitor length of stay, and ensure appropriate levels of care while supporting regulatory compliance and cost efficiency. Travel to system hospitals and quarterly time reporting are expected.