Director of Utilization Management Palo Alto Healthcare System
Veterans Affairs Palo Alto Health Care System
Location: Palo Alto, California
Type: Full Time
Hospital, Public and Private
Internal Number: -
The Veterans Affairs Palo Alto Health Care System office of Acute Care Hospital Operations (ACHO) is seeking a hospitalist to serve as Director of Utilization Management (UM). This highly visible position will directly oversee the process of inpatient utilization management for the hospital. S/he will ensure the provision of a continuum of high-quality care for our veterans by applying clinical knowledge and expertise to inpatient cases not meeting utilization criteria and formulating recommendations for optimal management of the patient. Through close collaboration with multiple inpatient sections, s/he will facilitate timeliness of services provided and compliance with standards of accrediting bodies. The Director of Utilization Management reports directly to the Deputy Chief of Staff for ACHO.
Serve as content expert for utilization management at the VA Palo Alto Health Care System. Understands the uses InterQual and other appropriateness criteria.
Recommends and oversees process improvement initiatives to optimize health care delivery by aligning InterQual appropriateness criteria with health care processes
Serve as Medicine Physician Utilization Management Advisor (PUMA) to reviews medical records of patients identified by utilization management or as requested by the health care team
Provide real-time feedback to attending and consulting physicians regarding level of care, length of stay, resource utilization, coordination of care, documentation, and evidence-based clinical practices
Attends daily patient flow meetings to align utilization management with the Clinical Command Center, the operations center for inpatient flow
Serve as liaison with the ED to discuss alternatives to acute care when acute care is not warranted
Seeks out best practices by conferring with other VA facilities as well as non-VA healthcare systems to review and implement successful methodologies
Effort and Leadership Structure
0.5 FTE toward Director of Utilization Management (but may be higher if responsibilities/duties warrant it)
0.5 FTE toward clinical work within the section of Hospital Medicine
The Director of Utilization Management reports directly to the Deputy Chief of Staff for ACHO
About the Section of Hospital Medicine
The VA Palo Alto Health Care System is a tertiary, regional referral center with a vital, close relationship with the Stanford School of Medicine. Our hospitalist group is a dynamic group of clinician-educators with a focus on team-based care, quality improvement, and innovative approaches to medical education. As a hospitalist, you will work closely with residents from the Stanford Internal Medicine Residency program and medical students to manage the full spectrum of acute inpatient medical conditions. Hospitalists will also provide consultative care to non-medicine services and participate in the co-management of patients on our orthopedic surgery, podiatry, and neurosurgery services. All patients on the medicine service are covered by teaching teams. Our hospitalists pursue a variety of academic initiatives including complex case presentations at multidisciplinary rounds, participation in our hospitalist teaching series, and involvement with numerous quality improvement initiatives.
Applicants must be US citizens and board-certified/eligible in Internal Medicine. Applicants must have a valid US medical license and demonstrate evidence of prior VA experience in utilization management. The ideal applicant will have at least 3 years’ experience and academic interests relevant to hospital medicine in quality improvement and administration.
About Veterans Affairs Palo Alto Health Care System
Providing Health Care for Veterans: The Veterans Health Administration is America’s largest integrated health care system, providing care at 1,255 health care facilities, including 170 medical centers and 1,074 outpatient sites of care of varying complexity (VHA outpatient clinics), serving 9 million enrolled Veterans each year.