Physician Supervisor, Utilization Management
$174,070–$374,920 year
On-site · Bellevue, Washington, United States
Job Summary
Physician Supervisor, Utilization Management leads and manages the UM team, overseeing medical necessity reviews, prior authorizations, concurrent and retrospective reviews, and coordination of healthcare services. Responsibilities include coaching and developing UM clinicians, guiding performance evaluations, ensuring compliance with federal/state/local regulations, and collaborating with Transitions, Case Management, and Care Teams to deliver high-quality, cost-effective care. Requires an MD or DO with an active US medical license, leadership experience, and deep knowledge of managed care, risk arrangements, capitation, peer review, performance profiling, and outcomes management. Demonstrated commitment to culturally responsive care and the ability to collaborate with a diverse group of leaders is essential.
Required Qualifications
- MD or DO degree required
- Current, unrestricted medical license in the United States (NCQA Standard)
- At least 2 years of experience providing Utilization Management services for Medicare/Medicaid
- 3-5 years of clinical practice in a primary care setting
- Graduate of an accredited medical school
- US work authorization
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