Job Description

Job Title: Medical Director for Clinical Effectiveness (Physician) - UPMC Passavant & UPMC St. Margaret
Job ID: 721991
Status: Full-Time
Regular/Temporary: Regular
Hours: Daylight, Monday thru Friday
Shift: Day Job
Facility: UPMC Passavant
Department: Administration
Location: 9100 Babcock Blvd, Pittsburgh PA 15237

Description

Are you a seasoned physician with a passion for community care? Do you enjoy working in a collaborative medical team? Do you have an interest in the administrative side of medicine? Consider this rare opportunity!

This position will work standard daylight hours Monday through Friday.

UPMC Passavant, together with UPMC St. Margaret, seeks a full-time Regional Medical Director to support our hospitals' community care and care management programs. This position will be physically based at UPMC Passavant in McCandless Township, located within the North Hills area of Pittsburgh.

UPMC St. Margaret is a 249-bed acute care and teaching hospital situated on a 21-acre campus near Aspinwall (Pittsburgh). It begins its second century of service with renewed dedication to more than 250,000 residents of northeastern Allegheny County and the Alle-Kiski Valley, providing residents convenient access to the area’s finest physicians and health services. UPMC St. Margaret also includes our affiliated outpatient centers in the surrounding area.

UPMC Passavant serves as UPMC’s tertiary care center north of Pittsburgh, bringing UPMC’s brand of world-class medical care to two convenient campuses in McCandless and Cranberry Townships to serve the communities and counties north of the city. At a total count of 415 beds, we provide advanced, high-quality care and all of the resources of an academic medical center are available closer to residents north of Pittsburgh.

Both UPMC St. Margaret and UPMC Passavant are Magnet designated hospitals. Magnet status is one of the the highest achievements an organization can obtain for nursing excellence and leadership. Only 8 percent of hospitals nationwide have received Magnet status.

The Medical Director is responsible for assuring the clinical effectiveness of UPMC Passavant and UPMC St. Margaret. The clinical effectiveness program is intended to improve the quality of care while concurrently reducing associated costs. These goals are achieved by the reduction of unwarranted variation in clinical processes and outcomes and are essential for success in the evolving value–based reimbursement environment. 

As Medical Director, you will have the significant responsibility for the Care Management Department and Quality, Safety, and Experience Department at UPMC Passavant and UPMC St. Margaret and will work closely with the directors of these departments as well as hospital CMOs, CNOs, and other leaders. The Medical Director also participates in policy development and strategic planning and serves as a resource to colleagues across the organizations.

Responsibilities:
  • Lead clinical effectiveness efforts at UPMC Passavant and UPMC St. Margaret.
  • Support UPMC System care management, cost reduction, quality improvement, patient safety, utilization, and other initiatives
  • Developmentally mutually supportive relationships with hospital executives, medical staff, nursing staff, and related departments
  • Focus on length of stay, readmission, mortality, consult utilization, and other hospital and medical staff metrics
  • Establish effective relationship with medical staff with an emphasis on medical necessity, discharge planning, and clinical documentation education and clinical performance reporting
  • Serve as liaison with employed and private physician groups; work closely with leadership of Hospitalist Program, CMI and UPP
  • From a payer denial management standpoint, serve as lead physician advisor for UPMC Passavant and UPMC St. Margaret and serve as backup for other UPMC business units including UPMC Jameson, UPMC Horizon, and Corporate Care Management
  • Recruit and train physician advisors for care management functions and monitor their performance 
  • Review cases in real-time to identify quality and utilization opportunities
  • Serve as physician expert for Care Management and Quality, Safety, and Experience departments at both hospitals with focus on increased physician and APP participation in these efforts
  • Partner with hospital Director of Care Management in departmental management and ongoing development of active care management strategies
  • Support practice guideline development and other clinical quality initiatives
  • Maintain momentum in meeting length-of-stay, observation rate, and readmission rate goals
  • Emphasize the close relationship between utilization and throughput
  • Establish good working relationships with third-party payers, especially UPMC Health Plan
  • Support Finance and Contracting departments at UPMC System and local levels
  • Develop expertise with UPMC System analytics tools to optimize clinical care
  • Advocate for UPMC System and local agenda on reimbursement, length of stay, operational efficiency, quality, safety, and regulatory compliance
  • Mentor other physicians in the development of leadership and administrative skills
  • Educate medical staff and APPs on appropriate clinical documentation
  • Provide feedback to medical staff on metrics such as length of stay, mortality, and readmissions via periodic Physician Scorecards
  • Serve on medical staff and hospital committees as assigned (Professional Practice Evaluation Committee, Board Quality, etc.)
    Ensure compliance with relevant Joint Commission standards, Department of Health regulations, and Medicare Conditions of Participation
    Other duties as assigned

Qualifications

  • Minimum 10 years clinical experience.
  • Doctor of Medicine or Doctor of Osteopathy from an accredited school. 
  • Unrestricted License in Pennsylvania.
  • Post residency clinical experience
  • Previous management experience preferred.
  • Experience in managed care setting preferred
  • Ability to implement medical policies, and to enforce those policies through appropriate action.
  • Ability to maintain effective professional liaison with all levels of executive and medical staff, including professional and institutional providers of care.
  • Ability to implement programs of quality care analysis, peer review, and professional education.
Licensure, Certifications, and Clearances:
  • Act 34 Criminal Clearance with Renewal
  • Medical Doctor
UPMC is an equal opportunity employer. Minority/Females/Veterans/Individuals with Disabilities

Salary Range: $0 to $0

Union Position: No

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