Physician Peer Review & Utilization Lead

Intermountain Health; Murray (UT); On-site; USD 10,000 - 1,378,000; Full time

Benefits offered by this job

Benefits package

Job summary

Intermountain Health Murray-based position seeking a physician leader to provide peer review and clinical direction for utilization management and related programs. The role collaborates with Benefits Determination, Quality Improvement, Behavioral Health, Pharmacy Services, and other departments to implement medical director policies and manage the provider panel.

The incumbent will review coverage and preauthorization decisions, contribute to guideline development, and participate in committees

Qualifications

• MD or DO with Board Certification in specialty.
• Current MD/DO licensure in Utah, Idaho, Nevada or Colorado.
• At least five years of clinical practice experience.
• Proven communication skills, both written and verbal.

Responsibilities

• Serve as physician peer reviewer and provide clinical direction for utilization management.
• Participate in UM criteria development and policy reviews.
• Support education for UM/CM and Health Care Services staff.
• Review preauthorization requests and document decisions in care management system.
• Represent Select Health on committees and contribute to delivery improvement.
• Assist with NCQA, HEDIS, and CAHPS certification activities.
• Align clinical practice with evidence-based standards across departments.

Skills

Leadership

Performance Metrics

Results-Oriented

Communication

Problem Solving

Taking Initiative

Analytical Thinking

Accountability

Collaboration

Professional Etiquette

Education

MD/DO with Board Certification

Job description

Intermountain Health Murray-based position seeking a physician leader to provide peer review and clinical direction for utilization management and related programs. The role collaborates with Benefits Determination, Quality Improvement, Behavioral Health, Pharmacy Services, and other departments to implement medical director policies and manage the provider panel.

The incumbent will review coverage and preauthorization decisions, contribute to guideline development, and participate in committees