UnityPoint Health

Medical Director-Clinical Documentation, Utilization/Denials

Requisition ID
2022-109302
Category
Hidden (27553)
Location
US-IA-Des Moines
Address
1200 Pleasant St
Affiliate
3020 UnityPoint Health Des Moines
City
Des Moines
Department
Administration
State
IA
FTE
1.0
FLSA
Exempt
Scheduled Hours/Shift
8 hours/Days
Work Type (Portal Searching)
Full Time Benefits

Overview

Medical Director (Clinical Education)- Methodist

Shift: Days; 40 hrs/wk 

Benefits Eligible 

 

The Medical Director participates in administrative decision-making, makes recommendations and participates in the  review and approval of medical staff and clinical documentation policies.  Serves as liaison between the Clinical Documentation Improvement (CDI) staff, Utilization Management, Physician Support, Payor Contracting, Health Information Management (HIM) Department, Medical Staff, and Administration to create a culture that is proactive in ensuring accurate clinical documentation to reflect quality patient care and positive outcomes. The Medical Director serves as a resource to hospital staff to share information regarding clinical documentation, reimbursement practices, healthcare trends, appropriate medical care and clinical workflows.

 

Why UnityPoint Health? 

  • Commitment to our Team – We’ve been named a Top 150 Place to Work in Healthcare 2022 by Becker’s Healthcare for our commitment to our team members. 
  • Culture – At UnityPoint Health, you Come for a fulfilling career and experience a culture guided by uncompromising values and unwavering belief in doing what's right for the people we serve. 
  • Benefits – Our competitive Total Rewards program offers benefits options that align with your needs and priorities, no matter what life stage you’re in. 
  • Diversity, Equity and Inclusion Commitment – We’re committed to ensuring you have a voice that is heard regardless of role, race, gender, religion, or sexual orientation. 
  • Development – We believe equipping you with support and development opportunities is an essential part of delivering a remarkable employment experience. 
  • Community Involvement – Be an essential part of our core purpose—to improve the health of the people and communities we serve. 

Visit us at UnityPoint.org/careers to hear more from our team members about why UnityPoint Health is a great place to work. https://dayinthelife.unitypoint.org/

 

Responsibilities

  • Promotes accurate and complete physician documentation during the patient’s course of care.
  • Fosters education and communication between the Physician Support team, CDI team and the medical staff.
  • Provides education and training activities to the medical staff members and other healthcare professionals to facilitate the accurate representation of the severity of illness (SOI) by improving the quality of the physician’s clinical documentation.
  • Improves and enhances the education of the CDI and Coding staff regarding clinical pathophysiology, new treatment modalities, and procedures that currently are practicing at the facility.
  • Conducts monthly education session with CDI/Coding staff on new treatments and/or procedures performed at the hospital or clinical topic chosen in advance by HIM Director and CDI staff.
  • Identifies and suggests topics for in-service training through observation and evaluation of the documentation trends and issues identified internally or externally.
  • Participates in the development of a formal training plan for medical staff regarding ICD-10 and Hospital Value-Based Purchasing (HVBP).
  • Writes articles for in-house publications.
  • Brings awareness to the clinical departments to demonstrate the importance of concurrent documentation in the health record to achieve complete and accurate documentation.
  • Helps develop, implement, and perform periodic evaluation of the medical staff, HIM, and CDI policies and procedures.
  • Keeps medical staff informed of changes in policies and procedures

Qualifications

 

Minimum Requirements

Preferred or Specialized

Education:

 

 

 

·       Hold an unrestricted medical license  in the state of Iowa

·       Completion of medical residency

 

Experience:

 

 

 

 

·       Experience with denials management.

·       Knowledge and experience in case management principles, processes, and practical application.

 

·       Experience in working with third-party payor guidelines/medical necessity criteria such as InterQual® (e.g., knowledge of admission criteria for all levels of care).

·       Experience in working with Centers for Medicare and Medicaid Services rules and regulations

·       Experience leading large-scale change efforts.

 

License(s)/Certification(s):

 

 

 

 

·       Valid driver’s license when driving any vehicle for work-related reasons.

 

Knowledge/Skills/Abilities:

 

 

 

 

·       Basic understanding of how clinical documentation affects the quality of care and outcome scores.

·       Has the ability to communicate in oral and written form to different stakeholders (physicians, ancillary staff, billing office, researchers and payers).

·       Teaching and coaching skills.

·       Analytical ability and problem-solving skills.

·       Working knowledge of electronic medical record.

·       Knowledge of process improvement methodology.

·       Knowledge of clinical, quality, and administrative facets of the healthcare industry.

·       Familiarity with clinical documentation requirements.

·       Collaborative attitude to enable a strong partnership with Case Management.

·       Clinical credibility among physician peers.

·       Persuasive and influential

 

·       Knowledge of ICD and/or CPT codes to physician source documentation in a clinical setting.

·       Knowledge of DRG and/or APC classification systems.

 

Other:

 

 

 

·       Use of usual and customary equipment used to perform essential functions of the position.

 

 

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