Clinical Documentation Improvement Medical Director

Position Type: Full Time

Location: ­­­­­­­­­Onsite positions in Newtown Square and/or remote opportunities

Versalus Health is an innovative, rapidly growing physician-led organization that provides hospitals with next-generation solutions focused on the intersection of utilization management, revenue cycle, and compliance. The company has a vibrant culture that strives to promote a positive work/life balance while allowing physicians to utilize their clinical skills in an environment that positively impacts healthcare. Versalus’ Medical Directors collaborate on teams and share their medical expertise while educating hospital clients. Come be a part of the Versalus team and positively change healthcare!

Job Description:

The CDI Medical Director acts as an expert clinical and educational resource to client hospitals by implementing real-time and project-based clinical documentation improvement, providing advisory compliance and educational services, and participating in periodic healthcare data audits and analyses. Advisory services are performed either onsite, electronically or over the phone.

Job Responsibilities:

  • Focused real-time chart reviews with an emphasis on improving physician documentation to support payment integrity and prevent payer denials
  • Documents patient care reviews, decisions, and appeals denials
  • Provides feedback to medical staff regarding level of care, length of stay, and clinical documentation
  • Provides education to physicians and other clinical staff related to regulatory requirements, utilization of resources and service management
  • Provide in-depth clinical expertise, educate treating physicians, and document clearly and concisely
  • Educate medical staff regarding coding guidelines, DRG assignment, severity of illness, and risk of mortality reporting
  • Educates medical staff regarding correct disease and public reportable data, and the need for accurate clinical documentation to capture profiling data
  • Collaborate with clinicians and coding professionals to review selected health records, explain clinical issues, and assist in developing appropriate and compliant clinical documentation queries
  • Involved in periodic data audit and analysis to identify areas of compliance risk and inefficiency, to improve real-time processes
  • Project-based review of charts from hospital clients for purposes of evaluating and explaining variance from expected outcomes
  • Promote hospital compliance with CMS policy regarding the Two-Midnight Rule
  • Additional responsibilities that would correlate with the growth of the company

Skills:

  • Strong clinical fund of knowledge
  • Excellent communication skills (verbal, written and listening)
  • Team Player
  • Collaborative
  • Computer proficient
  • Good problem solver with strong analytical skills
  • Organized
  • Professional
  • Understanding of Inpatient Prospective Payment System (IPPS) payment model and ICD-10-CM/PCS coding classification

Education/Experience Required:

  • MD or DO – with active license
  • Medical degree and postgraduate medical training from accredited clinical programs
  • Recent inpatient hospital experience
  • Previous physician advisor and/or medical director experience helpful but not necessary
  • Board certification preferred

Physical Requirements:

May be expected to sit at a desk for long hours.  Repetitive movement of hands and fingers – typing and/or writing.  Occasional standing, walking, stooping, kneeling or crouching.  Ability to reach with hands and arms, talk and hear. Exert up to 20 pounds of force occasionally and/or negligible amount of force frequently or constantly to lift, carry, push, pull or otherwise move objects.

Versalus Health is an Equal Opportunity Employer and considers applicants for employment without regard to race, color, religion, sex, orientation, national origin, age, disability, genetics or any other basis forbidden under federal, state, or local law.

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