Utilization Management Physician

Job description

Overview NaphCare is hiring a Utilization Management Physician to join our team at our Corporate Office in Birmingham, AL. The Utilization Management Physician will provide a streamlined, efficient, and consistent approach to the quality of patient care while supplementing onsite resources to prioritizing continuity of care, ensuring accuracy and follow through of care plans related to offsite patient encounters that focus on site resource availability and appropriate utilization. Responsibilities: - Review of offsite/specialty Returns, hospital returns (inpatient or observation status), and ER returns. Completing detailed review of records to make sure all consultant recommendations are reviewed and implemented, along with submitting follow up consult visits as recommended. - Site Maintenance to review facility queues. This is to ensure timely follow up in signing off orders and reordering medications. Sharing educational needs that are identified for providers and nursing to education department for follow up/training. - Review diabetic acuity reports, medical priority dashboard, and Coumadin patients charts to ensure plan of care, orders, appointments, etc. are appropriate and b...