Overview

Saint Francis Hospital Hospital is committed to providing exceptional patient care in a supportive and collaborative environment. As a member of our team, you will have the opportunity to work with advanced technology and be part of a healthcare community dedicated to making a positive impact on the lives of our patients.

At Saint Francis Hospital, we understand that our greatest asset is our dedicated team of professionals. That’s why we offer more than a job – we provide a comprehensive benefit package that prioritizes your health, professional development, and work-life balance. The available plans and programs include:

• Medical, dental, vision, and life insurance
• 401(k) retirement savings plan with employer match
• Generous paid time off
• Career development and continuing education opportunities
• Health savings accounts, healthcare & dependent flexible spending accounts
• Employee Assistance program, Employee discount program
• Voluntary benefits include pet insurance, legal insurance, accident and critical illness insurance, long term care, elder & childcare, auto & home insurance

Note: Eligibility for benefits may vary by location and is determined by employment status

Job Summary

Responsible for medical staff leadership to the Utilization Management Committee (UMC) and the Case Management (CM) and Health Information Management (HIM)/Clinical Documentation Improvement Departments. Leads and promotes processes for patients to receive medically necessary and high-quality care throughout the continuum of care. Stays abreast of professional best practices and community standards of care. Assists Administration in reducing financial risks associated with denials that are due to providing medically unnecessary or preventable services and extended length of stays.

Responsibilities

• Provide clinical leadership and guidance to the Utilization Management Committee (UMC), Case Management (CM), and Health Information Management (HIM)/Clinical Documentation Improvement (CDI) teams to support effective patient care and resource utilization.
• Promote medically necessary and high-quality care by leading initiatives that ensure appropriate patient treatment and services throughout the continuum of care.
• Collaborate with physicians and interdisciplinary teams to improve utilization management practices, patient outcomes, and compliance with regulatory and payer requirements.
• Maintain expertise in healthcare best practices and standards of care by staying current with industry guidelines, evidence-based medicine, and community care standards, and sharing this knowledge with medical staff.
• Support denial prevention and financial stewardship efforts by assisting administration in reducing financial risks related to medical necessity denials, preventable services, and unnecessary extended lengths of stay.
• Performs other duties as assigned/required.

Qualifications

• Required:
  • Education:  Doctor of Medicine Degree (M.D.) or Doctor of Osteopathic Medicine Degree (D.O.). 
  • Experience:  2 years in a physician leadership role.  
  • Licensure/Certification: 
    • Current State MD or DO License and an ABMS (American Board of Medical Specialties) Certification. 
    • AHA BLS.

• Preferred:
  • Education: Advanced degree in Business and/or Health Care Administration. 
  • Experience: 
    • Utilization Management and hospital committee chair
    • Demonstrated ability to work in a collegial role with members of the medical staff and to engage in education to hospital medical staff
    • Prefer successfully conducted physician to physician discussions with payers.

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Organization Description

Saint Francis Hospital-Memphis is a 479-bed full-service hospital located at 5959 Park Avenue in Memphis, TN.Offering a wide array of medical services, Saint Francis is noted for its many Centers of Excellence, including its Center for Surgical Weight Loss, Joint & Spine Center, Heart & Vascular Center, Chest Pain Emergency Center, and Surgical Services including its Center for Robotic Surgery, Diabetes Center, and Cancer Center.The hospital has been recognized for excellence of care by United Healthcare, CIGNA, Blue Cross/Blue Shield, and Aetna. Saint Francis Hospital serves as an academic training site for University of Tennessee Surgical, Family Practice, and Psychiatric Residents. The hospital is accredited by the Joint Commission on the Accreditation of Healthcare Organizations, the nations oldest and largest hospital accreditation agency. At Saint Francis Healthcare, you can grow your career skills and be a vital member of our team where we strive to be No. 1 in quality, safety and service excellence. Join our team!

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