Physician Peer Review & Utilization Policy Lead

Intermountain Healthcare; Murray (UT); On-site; USD 100,000 - 140,000; Part time

Job summary

Intermountain Health seeks a physician leader to provide peer review and clinical direction for Select Health, focusing on utilization management, case management, appeals, and policy development. You will collaborate across departments to implement programs for the Office of the Medical Director, manage the provider panel, and uphold high customer satisfaction.

This role emphasizes preauthorization review, education for UM/CM and HCS staff, and active committee representation to drive delivery

Qualifications

• MD or DO with board certification in a medical specialty.
• Active MD/DO license in UT, ID, NV or CO.
• Five years of clinical practice experience.
• Strong verbal, written, and interpersonal communication skills.

Responsibilities

• Act as the first level of reviews and appeals for panel providers or members' concerns regarding coverage/benefits issues or quality of care.
• Develop and review Utilization Management screening criteria & policies used in the preauthorization process.
• Participate in the yearly guideline review process.
• Participate in ongoing evaluation of the UM process.
• Represent Select Health on committees as assigned by the Medical Director.
• Provide clinical education to UM/CM and HCS staff as necessary to perform their function.

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 seeks a physician leader to provide peer review and clinical direction for Select Health, focusing on utilization management, case management, appeals, and policy development. You will collaborate across departments to implement programs for the Office of the Medical Director, manage the provider panel, and uphold high customer satisfaction.

This role emphasizes preauthorization review, education for UM/CM and HCS staff, and active committee representation to drive delivery