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Radiology Utilization Management Fellowship

The Department of Radiology at the University Of Illinois College Of Medicine has newly established a one year fellowship in Radiology Utilization Management. This is the first formal training opportunity offered in the area of Radiology Utilization Management. Curriculum for the fellowship is designed by the Department of Radiology in conjunction with UIC School of Public Health, UIC School of Business and The Northbrook Institute of Research and Development that specializes in Radiology Benefit Management. Fellowship curriculum is divided in three rotations, formal classroom post graduate courses, Department of Radiology and rotation at the Northbrook Institute of Research and Development (NIRD).

Curriculum for formal classroom training consists of US healthcare system overview, Law and the Healthcare system and introduction to accounting and finance. Curriculum for radiology rotation will focus on evidence based utilization of imaging modalities and implementation of the ACR's - Appropriateness Criteria Standards and Practice Guidelines participation in The UIC Hospital and Department of Radiology's quality and compliance initiatives. Rotation at the NIRD will focus on learning about the pre certification and approval process.

Applicants should be physicians with board certification in any medical/surgical fields, interested in a career in Utilization Management.

If you have any questions that are not answered to your satisfaction on this website, feel free to contact our department Educational Coordinators, Rachel Marks (radadmin@uic.edu).

Thank you for your interest in our program. We look forward to receiving your application.

Leonard Berlin, M.D.
Professor, UIC Department of Radiology
Director, Radiology Utilization Management Fellowship Program

Background Information
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Overutilization of radiologic imaging, in particular use of Computed Tomography (CT) and Magnetic Resonance Imaging (MRI) scanning, has captured the attention of the medical community, third party payers including Medicare and Medicaid, federal and state legislative bodies, and the public at large.  Of great concern is not only the geometric rise in medical costs resulting from this overutilization, but also, with regard to CT scanning and nuclear medicine diagnostic procedures, significant overexposure of patients to potentially harmful radiation.

There is a significant need to institute processes that can evaluate and confirm the need for medical imaging in specific circumstances.  Overutilization must be curtailed, but it must be done in a manner that does not diminish in any way the availability of the diagnostic and therapeutic imaging procedures to patients whose medical conditions require them.  Therefore, there is a significant need for the evaluation of appropriate and prudent utilization of all radiologic imaging modalities.

Role of UM Fellowship in the Healthcare Industry

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Our fellowship program is created to provide a bridge between the providers, the payers and the regulatory agencies. Radiology Utilization and Management Fellow (UM Fellow) is expected to learn about

  1. Overall organization of Healthcare system
  2. Basic business management, accounting and finance principals
  3. Appropriateness criteria set forth by the American College of Radiology (ACR) for different radiology exams, standards and practice guidelines for radiological imaging.
  4. Evidence based criteria for ordering and performing those exams
  5. Risks and benefits of performing each examination


Career Path After Fellowship
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After the graduation from this program, UM fellow has a vast variety of career paths to choose from. With the knowledge accumulated, a career heading utilization management department of a hospital, playing a leadership role in government or private payer organization or working in a leadership role in radiology benefit management organization.

UM Fellowship Structure & Rotations
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UM fellowship is a 12 month fellowship from July 1 through June 30 of the following year. Upon satisfactory completion of the course, a fellowship diploma will be awarded by the College of Medicine at the University of Illinois.

The contents and activities of the curriculum are designed to be an evidence based, system based, and practice-based learning process.

Curriculum times and dates assigned to the following activities, will be tailored to the physician’s primary specialty (Radiology, Medicine, Surgery, etc.)

UM Fellow will complete the following rotations:

  1. UIMC – Department of Radiology
    1. Real time “View box” learning of modality of choice for given medical conditions
    2. Familiarity with ACR’s appropriateness criteria standards and practice guidelines.
    3. Participation in quality assurance and compliance activities

Fellows will use the appropriateness criteria and the standards and practice guidelines for imaging procedures developed by the American College of Radiology and match them with the criteria developed by the payer groups to provide comprehensive evidence based guidelines for practicing clinicians. Fellows will be encouraged to make recommendations to the ACR and payors for possible revision of their guidelines.

Through “hands on” experience in reviewing the routine imaging procedures performed daily within the Radiology Department, fellows will gain practical  knowledge to master the applications for and indications of the use of the specific imaging modality of choice for any given medical condition.

  1. UIMC – Hospital
    1. Participate in utilization review process activities
    2. Participate in risk management process activities

By participation in the Hospital’s utilization management process, Radiology Department Quality Assurance Committee, and the Risk Management Office activities, fellows will gain significant knowledge and awareness regarding the activities of these entities not only in Radiology, but in the general practice of medicine as well.

  1. UIC School of Public Health and School of Business

Through enrollment in the courses specifically identified by the UIC’s Business and Public Health Schools for this program, fellows will learn basic principals of business especially as they relate to health care.  Fellows will also gain a general overview of the Public Health Policies.

    1. Introduction to the U.S. Healthcare System – (UIC School of public health) This course provides a dynamic overview of the structure and components of the current healthcare system.  It offers students a valuable perspective of the competing forces in the system, including: hospitals; long term care providers; primary care and specialty clinicians; the government; insurers; and, managed care organizations - Fall Semester.
    1. HPA 434 – Law and the Healthcare System - (UIC School of public health) This course is a survey of legal topics important to the management of healthcare organizations. They include: relationships among the parties involved in the delivery of healthcare; legal obligations of insurers and providers; legal issues arising in the context of restructuring health services; professional liability; consent, privacy of health information, patient rights and patient safety; and more - Spring Semester.
    1. ACCT 500 Introduction to Financial Accounting – (UIC School of Business) Concepts and principles of financial accounting for preparation and evaluation of external reports and financial statements. (Available online)
    1. FIN 500 Introduction to Corporate Finance - (UIC School of Business)
      Theory of corporate finance: goal of the firm, time value of money, investment decisions (under certainty and uncertainty), net present value, capital markets, and corporate financing decisions. Spring Semester
  1. Northbrook Institute for Research and Development

The Northbrook Institute for Research and Development is one of the leading institutions currently involved in radiology utilization management, providing pre-authorization for imaging procedures to health care insurance industry. More than 20 physicians work at the Institute. During the time fellows spend at the Institute, they will become familiar with and learn evidence-based utilization management and medical decision trees as developed by the healthcare industry.

 

Benefits
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Application Process
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Other Radiology Programs Offered
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University of Illinois at Chicago Medical Center
Department of Radiology (M/C 931)
1740 West Taylor Street, Room 2483
Chicago, IL 60612

Phone: (312) 996-0235
Fax: (312) 355-2098

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