Job opening: Physician Utilization Management Advisor
Salary: $115 587 - 282 480 per year
Published at: Jul 08 2023
Employment Type: Full-time
The Physician Utilization Management Advisor (PUMA) position accounts for patients hospitalized within the facility and in the community setting.
Duties
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Work Schedule: Monday - Friday, 9:00am - 5:30pm
Pay: Competitive salary, annual performance bonus, regular salary increases
Paid Time Off: 50-55 days of paid time off per year (26 days of annual leave, 13 days of sick leave, 11 paid Federal holidays per year and possible 5 day paid absence for CME)
Retirement: Traditional federal pension (5 years vesting) and federal 401K with up to 5% in contributions by VA
Insurance: Federal health/vision/dental/term life/long-term care (many federal insurance programs can be carried into retirement)
Licensure: 1 full and unrestricted license from any US State or territory
CME: Possible $1,000 per year reimbursement (must be full-time with board certification)
Malpractice: Free liability protection with tail coverage provided
Contract: No Physician Employment Contract and no significant restriction on moonlighting
Physician Utilization Management Advisor (PUMA) position description
Community Inpatient Care
Account for patients hospitalized in the community
Tracking huddle report using Excel spread sheet
Huddle with MOMMC and Community Care
Coordinate with community hospital for discharge planning for NSC and non-CNH program eligible Veterans
Supervision and guidance for utilization management for Veterans hospitalized in the community
Collaboration with utilization nurses in care coordination while patient is hospitalized and providing information to the Pact Team of subsequent needs of the Veteran post discharge
Review and approval of major surgery/procedures
Coordinate tertiary care transfer from Community hospital (heart/LVAD, bone marrow transplant, etc) to another facility outside of the local VA
VAMC Inpatient Care and NUMI
Collaboration with UM nurses
Secondary review completion when needed
Review and adjudicate request for transfer to Community Inpatient Care (ensure that request meets criteria)
Long Term Acute Care (LTAC) authorization and utilization management (UM) follow up at LTAC
Qualifications
To qualify for this position, you must meet the basic requirements as well as any additional requirements (if applicable) listed in the job announcement. Applicants pending the completion of training or license requirements may be referred and tentatively selected but may not be hired until all requirements are met. Currently employed physician(s) in VA who met the requirements for appointment under the previous qualification standard at the time of their initial appointment are deemed to have met the basic requirements of the occupation.
Basic Requirements:
United States Citizenship: Non-citizens may only be appointed when it is not possible to recruit qualified citizens in accordance with VA Policy.
Degree of doctor of medicine or an equivalent degree resulting from a course of education in medicine or osteopathic medicine. The degree must have been obtained from one of the schools approved by the Department of Veterans Affairs for the year in which the course of study was completed.
Current, full and unrestricted license to practice medicine or surgery in a State, Territory, or Commonwealth of the United States, or in the District of Columbia.
Residency Training: Physicians must have completed residency training, approved by the Secretary of Veterans Affairs in an accredited core specialty training program leading to eligibility for board certification. (NOTE: VA physicians involved in academic training programs may be required to be board certified for faculty status.) Approved residencies are: (1) Those approved by the Accreditation Council for Graduate Medical Education (ACGME), b) OR
[(2) Those approved by the American Osteopathic Association (AOA),OR
(3) Other residencies (non-US residency training programs followed by a minimum of five years of verified practice in the United States), which the local Medical Staff Executive Committee deems to have provided the applicant with appropriate professional training and believes has exposed the physician to an appropriate range of patient care experiences.
Residents currently enrolled in ACGME/AOA accredited residency training programs and who would otherwise meet the basic requirements for appointment are eligible to be appointed as "Physician Resident Providers" (PRPs). PRPs must be fully licensed physicians (i.e., not a training license) and may only be appointed on an intermittent or fee-basis. PRPs are not considered independent practitioners and will not be privileged; rather, they are to have a "scope of practice" that allows them to perform certain restricted duties under supervision. Additionally, surgery residents in gap years may also be appointed as PRPs.
Proficiency in spoken and written English.
Preferred Experience:
At least 5 years of direct outpatient care or 2 years of inpatient care
Reference: VA Regulations, specifically VA Handbook 5005, Part II, Appendix G-2 Physician Qualification Standard. This can be found in the local Human Resources Office.
Physical Requirements: Applicants must meet physical standards for the position. A physical examination prior to placement is required. This is a designated drug testing position. After appointment, you will be subject to random testing for illegal drug use. Requires lifting 15-44 pounds; pushing (approx. 2 hours); reaching above shoulder; use of fingers and both hands; walking and standing from 3-5 hours and kneeling. Ability for rapid mental and muscular coordination simultaneously. Must have depth perception and ability to distinguish basic colors and shades of colors. Hearing aid is permitted.
Education
Degree of Doctor of Medicine or an equivalent degree resulting from a course of education in allopathic medicine or osteopathic medicine. The degree must have been obtained from an institution whose accreditation was in place for the year in which the course of study was completed. Approved schools are:
- Schools of medicine accredited by the Liaison Committee on Medical Education (LCME) for the year in which the degree was granted, or
- Schools of osteopathic medicine approved by the Commission on Osteopathic College Accreditation of the American Osteopathic Association for the year in which the degree was granted.
- For foreign medical graduates not covered in (1) or (2) above, facility officials must verify with the Educational Commission for Foreign Medical Graduates (ECFMG) that the applicant has met requirements for certification, and must obtain a copy of the ECFMG certificate, if claimed by the applicant. [If the applicant does not claim an ECFMG certificate, facility officials must still confirm that the medical school meets (or met) ECFMG eligibility requirements for the year the candidate graduated.]
NOTE: The Under Secretary of Health or designee in the VHA Central Office may approve the appointment under authority of 38 U.S.C. 7405 of a physician graduate of a school of medicine not covered above if the candidate is to be assigned to a research, academic, or administrative position with no patient care responsibilities. The appointment will be made only in exceptional circumstances where the candidate's credentials clearly demonstrate high professional attainment or expertise in the specialty area.
Contacts
- Address Las Vegas VA Medical Center
6900 North Pecos Road
North Las Vegas, NV 89086
US
- Name: Carmen Pilman
- Phone: (650) 512-7041
- Email: [email protected]
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