COVID-19 Vaccination Information

Across UPMC, our guiding principle is to always prioritize the safety of our employees, patients, and members. UPMC believes that vaccination is important, helps protect all, and advocates that everyone who can be vaccinated should be vaccinated.

UPMC complies with all governmental requirements related to local, state, and federal COVID-19 vaccination for employment. The Jan. 13 Supreme Court of the United States decision that the Centers for Medicare & Medicaid Services federal COVID-19 vaccine mandate will move forward requires UPMC to ensure employees either get vaccinated or receive a requested medical or religious exemption.

If you are not yet vaccinated, we urge you to get a vaccine now. You can schedule your COVID-19 vaccination through UPMC or visit a non-UPMC provider or UPMC Urgent Care location.

Proof of vaccination is not required upon hire; however, employees will be responsible for ensuring post-hire compliance by getting vaccinated or requesting a medical or religious exemption.

For more information about UPMC’s response to COVID-19, please visit UPMC.com/coronavirus.

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   Current UPMC employees must apply in HR Direct

Medical Director - Remote

Description

Combine your leadership skills and physician experience to take the next step in your career!  In this role, you will act as a physician leader in utilization management and quality improvement review processes. If you're a natural people-person passionate about Life Changing Medicine and making an impact in the world of healthcare, we invite you to join our team today!

The Medical Director is responsible for assuring physician commitment and delivery of comprehensive high-quality health care to UPMC Health Plan members. This role oversees adherence to quality and utilization standards through committee delegations and further establishes an effective working relationship between UPMC Health Plan's Network and its physicians, hospitals, and other providers.

The selected candidate will have the opportunity to work remotely.  UPMC offers a premier benefits package, designed to care for your total well-being — physically, emotionally, and financially — paired with endless opportunities for career advancement and growth.  Discover the culture, the teams, and the passions that drive us to make Life Changing Medicine happen. 

Responsibilities:

  • Provide leadership direction for provider credentialing processes.
  • Physicians must devote sufficient time to the CHC-MCO to provide timely medical decisions, including after-hours consultation, as needed
  • Provide leadership and direction in meeting Quality Improvement and Care Management goals directed at improvements in member health status outcomes and established business strategies.
  • Provide expedited review and determination of medically pressing issues in accordance with the established policies of the Health Plan.
  • Actively participates in the daily utilization management and quality improvement review processes, including concurrent, prospective and retrospective reviews, member grievances, provider appeals, and potential quality of care concerns.
  • Keep current with accepted standards and professional developments in the areas of quality improvement and utilization management.
  • Communicate and educate network providers regarding clinical guidelines, pathways, protocols, and standards related to quality and utilization processes.
  • Responsible for reporting the communication of reportable communicable diseases in accordance with statute.
  • Interacts with physicians regarding opportunities to improve member satisfaction and compliance with Utilization Management and Quality Improvement policies and procedures.
  • Work with the DOH State and District Office Epidemiologists in partnership with the designated county/municipal health department staff to appropriately report reportable conditions in accordance with 28 Pa. Code 27.1 et seq.
  • Daily interventions support implementation of the Health Plan's Quality Improvement and Care Management Programs.
  • Represent the Health Plan in external accreditation and certification activities.
  • Act as first-level physician reviewer for all cases referred by the Quality Improvement and Care Management Departments.
  • Daily activities support adherence to quality and utilization standards and establish an effective working relationship between UPMC Health Plan's Network and its physicians, hospitals and other providers.

 

Qualifications

  • Doctor of Medicine or Doctor of Osteopathy from an accredited school.
  • Utilization management or Medicare experience preferred.

Licensure, Certifications, and Clearances:

  • Doctor of Medicine (MD) OR Doctor of Osteopathic Medicine (DO)

UPMC is an Equal Opportunity Employer/Disability/Veteran

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More than just competitive pay and benefits, UPMC’s Total Rewards package cares for you in all areas of life — because we believe that you’re at your best when receiving the support you need: professional, personal, financial, and more.

Our Values

At UPMC, we’re driven by shared values that guide our work and keep us accountable to one another. Our Values of Quality & Safety, Dignity & Respect, Caring & Listening, Responsibility & Integrity, Excellence & Innovation play a vital role in creating a cohesive, positive experience for our employees, patients, health plan members, and community. Ready to join us? Apply today.

   Current UPMC employees must apply in HR Direct

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