Physician-Physician Utilization Management Advisor (PUMA)

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.

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

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 allopathic 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 accrediting bodies for graduate medical education, the Accreditation Council for Graduate Medical Education (ACGME) or American Osteopathic Association (AOA), in the list published for the year the residency, or fellowship if applicable, was completed; OR
  • (2) One year of post medical school training (internship, first year of residency, or transitional year residency) approved by ACGME or AOA followed by two years of post-training independent practice (performing under a full and unrestricted license) in the United States; OR
  • (3) Non-US residency training programs followed by a minimum of three years of verified independent practice in the United States (performing under a full and unrestricted license) performing duties related to the position they are applying for (United States fellowships would be creditable towards this requirement), 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.
  • Exceptions:
    • 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 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.
    • In rare and unusual circumstances, the Facility Director can submit a memo to the VISN Director through the VISN Chief Medical Officer, who may approve requests for reasonable exceptions to the residency training requirement for Physicians whose composite record of experience, accomplishments, performance, and qualifications warrant such action.
• Proficiency in spoken and written English.

Reference: For more information on this qualification standard, please visit https://www.va.gov/ohrm/QualificationStandards/.

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:

1. Schools of medicine accredited by the Liaison Committee on Medical Education (LCME) for the year in which the degree was granted.
2. Schools of osteopathic medicine approved by the Commission on Osteopathic College Accreditation (COCA) for the year in which the degree was granted.
3. 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.