Physician-Physician Utilization Management Advisor (PUMA)

<p>The Michael E. DeBakey VA Medical Center serves as the primary health care provider for more than 151,000 Veterans in southeast Texas. Houston exudes a cosmopolitan and down-home vibe together that lets the residents of the country's fourth-largest city and third-largest county (Harris) know that there's no place quite like Houston. The city attracts visitors and transplants with a wonderful mix of world class arts, booming business, pro sports and award-winning cuisine.</p><h3>Major Duties</h3><p>VA offers a comprehensive total rewards package. VHA Physician Total Rewards. 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 Duties include, but not limited to: Review cases in the community that need additional guidance and conduct needs-based reviews and modifications for patient care coordination. Proactively partner with all staff in developing organizational systems for Care in the Community (CITC) using lean management principles to measure quality initiatives for facility performance effectiveness. Responsible for monitoring and advancing patient safety quality standards and utilization management for the Care in the Community (CITC) Department. Serves as the Lead for all committees related to Community Care. Serves as a vital resource and advisor for programmatic, clinical or other crucial Veterans health issues and inquiries. Represents MEDVAMC Community Care on National Committees (i.e. weekly VHA Consult PI call and Field Advisory call) and serves on other groups in MEDVAMC or VISN as needed. Ensures provision of comprehensive care for the target population through the utilization of interdisciplinary teams, care management and application of evidence- based clinical practices. Ensures implementation of annual Integrated community line specific performance measures for Network-level evaluation to aid in the development of efficient and effective delivery of services. Maintains accountability within the service line by 1) monitoring various metrics specific to the specialty; 2) analyzing and developing actions to improve metrics; and 3) standardizing workload expectations for clinicians/providers. Coordinates program improvement through (a) Leveraging relationships with facility, VISN and national leadership (b) didactics and other learning modalities; and (c) Site visits. Plans for future access points, taking into consideration the geographic distribution of the target population and including analysis of disease prevalence. Fosters interdisciplinary input into service line evolution. Implements and oversees Network-wide virtual care strategies. Establishes an environment that integrates educational and research activities within the service line's primary function of coordinating patient care services in the community. Develops and implements an Integrated Clinical Community Care department, that guides, supports and evaluates provision of consistent services to patients across all categories of care. Communicates effectively with staff, patients and stakeholders within the service area and throughout the VAMC and VISN. Assumes a leadership role in Strategic Planning and implementation on health concerns related to the Care of Veterans receiving community care. Serves as the MEDVAMC Community Care Whole Health Initiative representative. Mentors MEDVAMC clinical leaders. Work Schedule: Monday-Friday, 8:00am-4:30pm</p><h3>Requirements</h3>U.S. Citizenship; non-citizens may only be appointed when it is not possible to recruit qualified citizens in accordance with VA Policy. All applicants tentatively selected for VA employment in a testing designated position are subject to urinalysis to screen for illegal drug use prior to appointment. Applicants who refuse to be tested will be denied employment with VA. Selective Service Registration is required for males born after 12/31/1959. Must be proficient in written and spoken English. Subject to background/security investigation. Selected applicants will be required to complete an online onboarding process. Acceptable form(s) of identification will be required to complete pre-employment requirements (https://www.uscis.gov/i-9-central/form-i-9-acceptable-documents). Effective May 7, 2025, driver's licenses or state-issued identification cards that are not REAL ID compliant cannot be utilized as an acceptable form of identification for employment. Must pass pre-employment physical examination. Participation in the seasonal influenza vaccination program is a requirement for all Department of Veterans Affairs Health Care Personnel (HCP). You may be required to serve a probationary period. Complete all application requirements detailed in the "Required Documents" section of this announcement.<h3>Education</h3>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. Schools of osteopathic medicine approved by the Commission on Osteopathic College Accreditation (COCA) for the year in which the degree was granted. For foreign medical graduates not covered in (1) or (2) above, confirmation must be made that the medical school meets (or met) Educational Commission for Foreign Medical Graduates (ECFMG) eligibility requirement for year 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.