Medical Director for Care Management (MDCM)
Medical Director for Care Management (MDCM)
System Wide Full Time Position with LifeBridge Health
Reports to Chief Population Health Medical Directing Officer
Based in Baltimore, Maryland at Sinai Hospital
This position is a key member of the organization’s Care Management leadership team. Charged with meeting the organization’s goals and objectives for assuring the effective, efficient utilization of health care services. This system executive role oversees all hospitals in the health system to develop expertise on matters regarding physician practice patterns, over and under-utilization of resources, medical necessity, levels of care, care progression, denial management, compliance with governmental and private payer regulations, appropriate physician coding and documentation requirements. Each hospital has a site-specific Physician Advisor with whom the MDCM will be integrated closely in a complementary fashion with clear roles and responsibilities defined between the two roles.
The MDCM works closely with the medical staff leadership including Chief Medical officers and Chiefs of Service, the entire medical staff, facility specific Physician Advisors, care management Directors, care management teams, and financial services to develop and implement methods to optimize use of hospital services for all patients while also ensuring the quality of care provided. This includes working with hospital leadership in developing care management protocols with physicians and others to optimize length of hospital stay and efficient management of resources, insuring patients are in the appropriate level of care, supporting documentation, coding improvements and compliance, and monitoring the appropriate use of diagnostic and therapeutic modalities.
If you possess these qualifications, please apply immediately
- Hold and maintain an unrestricted medical license in the state of Maryland.
- Must be able to meet the requirements (and become a member) of the Hospital medical staff. Board certification required.
- Solid foundation, knowledge, and/or experience in the areas of utilization management, quality improvement, and patient safety.
- Working knowledge of case management operations and administrative standards and policies.
- Strong computer skills and working knowledge of the EMR - Cerner.
- Ability to build rapport with medical staff and hospital leadership
- Meet production standards within established time requirements.
- Maintains confidentiality of patient care and business matters.
- Participate in ongoing training and education related to the MDCM role.
- Obtain familiarity and working knowledge of standard published criteria such as MCG/InterQual. Familiarity with MCG/Interqual placement status criteria is preferred.
- Member of the American College of Physician Advisors (ACPA) preferred.
- Board Certification by the American Board of Quality Assurance and Utilization Review Physicians, Inc. (ABQAURP) preferred.
- Physician Advisor Sub-Specialty Certification by the American Board of Quality Assurance and Utilization Review Physicians, Inc. (ABQAURP) preferred.
Organizational Leadership Requirements
- Excellent customer service and interpersonal skills.
- Able to effectively present information, both formal and informal.
- Strong analytical skills.
- Strong written and verbal communications skills.
- Strong organizational skills and ability to set priorities and multi-task, demonstrates flexibility, teamwork, and is accustomed to change in the healthcare environment.
- Demonstrate ability to drive results and produce outcomes.
Full benefits including Medical, Dental, and Vision plans, Pension plan, 401(k) retirement plan, 457(b) deferred compensation plan, life insurance, annual paid time off, CME allowances, potential for PFP bonus, discounted membership to our 70,000 square-foot award winning Health and Fitness center.
About LifeBridge Health and Sinai Hospital
Why work for LifeBridge Health? As the largest, most comprehensive, and most highly respected provider of health services to the families of the greater Baltimore region and beyond, LifeBridge Health is a model of excellence for both Physicians, Advanced Practice Providers, employees and the surrounding community. Our hospitals include Sinai Hospital of Baltimore, Northwest Hospital, Carroll Hospital, Levindale Hebrew Geriatric Center and Hospital, and Grace Medical Center. Each year we have more than 1 million annual patient encounters, offering outstanding primary and specialty care.
We are in Baltimore which is Maryland’s largest city and just 40 miles from Washington, D.C. It is the second largest seaport in the Mid-Atlantic and home to about 2.8 million people. Baltimore offers excellent medical facilities, educational institutions, entertainment, sports venues, and restaurants.
Join us; Care Bravely.
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