Physician Peer Review & Utilization Lead

Intermountain Health; Murray (KY); On-site; USD 827,000 - 1,378,000; Full time

Job summary

Intermountain Health's Select Health Murray location seeks a physician to provide peer review and clinical direction across utilization management, case management, and policy development. The role requires collaboration with multiple departments to implement programs for the Office of the Medical Director and to manage the provider panel while maintaining high customer satisfaction.

The position emphasizes education, committee representation, and ongoing quality improvement, with a focus on

Qualifications

• Medical Doctor or DO with board certification in specialty.
• Current MD/DO license in Utah, Idaho, Nevada or Colorado.
• Five years of clinical practice experience.
• Strong verbal, written, and interpersonal communication skills.

Responsibilities

• Act as the first level of reviews and appeals for coverage/benefits issues or quality of care.
• Develop and review Utilization Management screening criteria & policies for preauthorization.
• Participate in physician specialty peer review to support turnaround times by accrediting bodies.
• Provide clinical education to UM/CM/HCS staff as needed.
• Review preauthorization requests and document decisions in the care management system.
• Represent Select Health on committees as assigned by the Medical Director.
• Advise on care delivery improvements and cost reduction while maintaining quality.
• Assist with NCQA, HEDIS, and CAHPS certifications and other regulatory requirements.

Skills

Leadership

Performance Metrics

Results-Oriented

Communication

Problem Solving

Taking Initiative

Analytical Thinking

Accountability

Collaboration

Professional Etiquette

Education

MD/DO board certified

Job description

Intermountain Health's Select Health Murray location seeks a physician to provide peer review and clinical direction across utilization management, case management, and policy development. The role requires collaboration with multiple departments to implement programs for the Office of the Medical Director and to manage the provider panel while maintaining high customer satisfaction.

The position emphasizes education, committee representation, and ongoing quality improvement, with a focus on