What are the responsibilities and job description for the Physician - Medical Director - Utilization Management position at FirstHealth of the Carolinas, Inc.?
Overview:
About FirstHealth of the Carolinas:
About Pinehurst:
** Sorry, NO visa sponsorship available **
For more information and to apply, please contact our in-house Physician Recruitment team at FHPG-Recruitment@firsthealth.org.
Unique opportunity to make a measurable impact on healthcare delivery and quality!
Dynamic physician leader needed to champion FirstHealth’s Utilization Management efforts. We are a private, community-based healthcare system with four hospitals serving 15 counties in the mid-Carolinas. Our organizational culture is guided by a commitment to patient safety, quality, and performance excellence.
Position Highlights:
About the Opportunity:
- On-site position based at our flagship campus in Pinehurst, NC.
- Serve as the clinical expert on physician practice patterns, over- and under-utilization of resources, medical necessity, levels of care, care progression, denial management, compliance with governmental and private payer regulations, appropriate physician coding, and documentation requirements.
- Work closely with medical staff leadership, all medical staff, and ancillary departments to optimize services and ensure appropriateness of patient care.
- Collaborate with hospital leadership to develop care management protocols that drive improvements and effectively manage resources.
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Enjoy a comprehensive compensation and benefits package:
- Guaranteed base salary
- Health, life, and disability coverage
- 3 retirement savings plans – 401a, 403b with match, 457b
- Paid time off benefits
- CME allowance, license, and DEA reimbursement
- Customized wellbeing resources
- Free fitness center membership
- Paid Parental Leave
- Paid malpractice with tail coverage
About FirstHealth of the Carolinas:
- Financially stable organization with four hospitals,facilities for inpatient/outpatient rehabilitation, hospice, a palliative care program, home care, community outreach programs, integrated neurosciences, health & fitness centers, primary care, functional & concierge medicine, convenient care clinics, a hospitality house, EMS, a philanthropic foundation, and more.
- Here you will find specialty and subspecialty services and technologies that rival those typically only found in academic institutions and in larger metropolitan areas.
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Recent awards and achievements:
- Ranked #5 in NC on U.S. News & World Report’s list of Best Hospitals for 2025.
- Recognized by the American Heart Association for excellence in stroke and heart failure care.
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2025 Outstanding Patient Experience Award recipient by Healthgrades –
our 18th consecutive year! - On the Forbes list of America's Best Large Employers for 2025
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One of the Top 150 Places to Work in Health Care by Becker’s Healthcare –
3 years running!
- Be part of our mission-driven team—on a journey to zero harm and to be the best place to work in healthcare.
About Pinehurst:
- Located in the heart of North Carolina, Pinehurst offers a blend of Southern charm, outdoor recreation, and upscale amenities.
- Home to over 40 golf courses and host to multiple U.S. Open Championships.
- Convenient location: 1 hour from Raleigh-Durham, 2 hours from Charlotte, and 3 hours to the beach or mountains.
- Strong, diverse economy supported by tourism, healthcare, small manufacturing, education, and entrepreneurship.
- Exceptional quality of life with a temperate four-season climate and access to both rural tranquility and urban convenience.
- Consistently ranked among North Carolina’s safest communities and top micropolitan areas by POLICOM.
- Neighboring Southern Pines offers premier equestrian facilities, training centers, and boarding stables.
- MD or DO degree.
- Current CHCQM-PHYADV certification, or ability to obtain within 90 days of employment.
- Current ABMS or AOA board certification.
- Active, unrestricted NC medical license.
- 5 years of post-residency clinical practice experience PLUS at least one year of prior UM experience.
- Demonstrated leadership skills and the ability to influence others.
- Thorough understanding of current CMS and DNV compliance requirements
- Robust knowledge of hospital coding and billing, payer contracting, and revenue cycle management.
- Effective collaboration with physician peers, administration, and support staff.
- Advanced proficiency with EMRs and utilization review tools.
** Sorry, NO visa sponsorship available **
For more information and to apply, please contact our in-house Physician Recruitment team at FHPG-Recruitment@firsthealth.org.
