Grow Healthy
If you are as passionate about helping those in need as you are about growing your career, consider AltaMed. At AltaMed, your passion for helping others isn’t just welcomed – it’s nurtured, celebrated, and promoted, allowing you to grow while making a meaningful difference. We don’t just serve our communities; we are an integral part of them. By raising the expectations of what a community clinic can deliver, we demonstrate our belief that quality care is for everyone. Our commitment to providing exceptional care, despite any challenges, goes beyond just a job; it’s a calling that drives us forward every day.
Job Overview
The Associate Medical Director, Utilization Management position manages and supervises multi-disciplinary teams, as well as provides comprehensive, coordinated, physician reviews at LSMA. The AMD establishes, updates and improves work procedures and standards that achieve health plan, state and federal requirements, regulation and compliance, inclusive of utilization management outpatient prior authorization and concurrent reviews, as well as, case/care management for all services lines, including specialty care, diagnostics, procedures, home health, physical therapy, hospice and Durable Medical Equipment (DME). The AMD ensures execution of evidence-based clinical guidelines and community standards to achieve high quality affordable health care. In addition, the AMD spend a minimum of 80% of their time on direct physician review duties and 20% of their time on administrative duties to achieve medical management goals aligned with LSMA’s strategic priorities. The AMD actively participates in working with health services leadership to provide enterprise, regional and clinic specific data to receive and provide feedback to clinic leaders and providers on improving Utilization Management. The AMD has extensive experience and education and will train multi-disciplinary teams on appropriateness of care, quality and population health, patient/provider experience and appropriate documentation.
Minimum Requirements
1. A valid, unrestricted license to practice medicine in the State of California and Board certification in the chosen specialty required.
2. Minimum of 3 years of clinical practice in direct patient care required.
3. Minimum of 3 years of medical management experience in a managed care setting.
4. Demonstrated knowledge of managed care operations processes and managed care contracting, including Capitation and Risk Pool Management also required.
5. Past UM experience at the IPA or Health Plan level is highly desirable.
6. Electronic Medical records and referral management systems experience preferred.
Compensation
$245,489.92 - $306,862.40 annually
Compensation Disclaimer
Actual salary offers are considered by various factors, including budget, experience, skills, education, licensure and certifications, and other business considerations. The range is subject to change. AltaMed is committed to ensuring a fair and competitive compensation package that reflects the candidate's value and the role's strategic importance within the organization. This role may also qualify for discretionary bonuses or incentives.
Benefits & Career Development
Job Advertisement & Application Compliance Statement
AltaMed Health Services Corp. will consider qualified applicants with criminal history pursuant to the California Fair Chance Act and City of Los Angeles Fair Chance Ordinance for Employers. You do not need to disclose your criminal history or participate in a background check until a conditional job offer is made to you. After making a conditional offer and running a background check, if AltaMed Health Service Corp. is concerned about a conviction directly related to the job, you will be given a chance to explain the circumstances surrounding the conviction, provide mitigating evidence, or challenge the accuracy of the background report.
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