Medical Director

Accuity; United States; On-site; USD 180,000 - 240,000; Full time

Job summary

Accuity seeks a Medical Director to lead an interdisciplinary team reviewing inpatient charts to ensure acuity and complexity are accurately captured in documentation and coding, aligned with federal laws and privacy practices.

The Medical Director collaborates with a DRG Integrity Specialist to confirm principal diagnoses and DRGs, validate indicators for CC/MCC, and ensure accurate severity of illness representation across cases.

Qualifications

• Graduate from an accredited medical school
• Preferred completion of an ACGME accredited US residency program
• Minimum of a total of 5 years of clinical experience including residency
• Ability to lead an inter-disciplinary team and comply with medical and federal guidelines

Responsibilities

• Provide clinical leadership in an inter-disciplinary team to drive client results and foster confidence
• Maintain collaboration with the DRG Integrity Specialist to achieve shared goals
• Comply with medical and federal guidelines at all times
• Resolve conflicts quickly and professionally
• Stay up to date with medical guidelines and client criteria
• Ensure quality by developing and implementing strategic goals for quality improvement
• Generate compliant queries based on clinical indicators for each diagnosis
• Review tower analytics with management to identify trends and opportunities
• Adhere to organizational goals and participate in corporate education
• Utilize EMR systems proficiently and work effectively in a fast-paced environment
• Exceed expectations in productivity and quality of tower work
• Take on leadership responsibilities at a departmental level
• Perform other duties as assigned

Skills

Academic Excellence

Leadership

Service & Humanism

Diversity

Teamwork

MS Office

Windows PC skills

Remote/On-site

Education

MD degree

US residency (ACGME)

Job description

Position Summary

The Medical Director, working together with a coder (DRG Integrity Specialist), will review inpatient charts to ensure the acuity and complexity of the patient’s hospital stay is appropriately captured in the clinical documentation and translated into coding. The Medical Director is responsible for capturing the true clinical picture in a manner compliant with federal laws and the healthcare organization’s information privacy practices through identification of coding and physician query opportunities. The Medical Director is responsible for overseeing every chart assigned to their team.

Position Summary

The Medical Director, working together with a coder (DRG Integrity Specialist), will review inpatient charts to ensure the acuity and complexity of the patient’s hospital stay is appropriately captured in the clinical documentation and translated into coding. The Medical Director is responsible for capturing the true clinical picture in a manner compliant with federal laws and the healthcare organization’s information privacy practices through identification of coding and physician query opportunities. The Medical Director is responsible for overseeing every chart assigned to their team. The Medical Director works with the DRG Integrity Specialist to confirm the principal diagnosis and the appropriate Diagnosis Related Group (DRG) of every case in compliance with coding guidelines. This process also involves the Medical Director confirming procedures, dates, and complication or comorbidity (CC) or major complication or comorbidity (MCC) when used as a secondary diagnosis. The Medical Director validates clinical indicators for coded diagnoses, capturing the patient’s condition and ensuring the accuracy of the severity of illness and risk of mortality for the patient to illustrate the true clinical picture of the episode of care.

Primary Job Responsibilities

• Provide clinical leadership in an inter-disciplinary team in a professional, knowledgeable, and efficient manner to drive client results, exceed client expectations, and foster client confidence
• Maintain a functional and collaborative relationship with the DRG Integrity Specialist to achieve shared company goals
• Comply with medical and federal guidelines at all times
• Resolve conflicts quickly and professionally
• Stays up to date with medical guidelines, advancements within his or her field, and client-specific criteria
• Responsible for the quality of their teams work by developing and implementing strategic goals related to quality improvement within the tower
• Responsible for generating compliant queries based on appropriate clinical indicators for each diagnosis. Every query must meet all regulatory and reporting requirements
• Work with their manager to review tower analytics, identifying trends and actionable steps to improve opportunity capture rate and drive results for clients
• Work with Senior Management and Compliance Officer to adhere to organizational goals and mission
• Participate in corporate educational activities
• Utilize all technology, tools and resources to enhance performance and will be proficient in navigation of various electronic medical records
• Excel in a fast-paced, rapidly changing environment
• Exceed expectations in performance with regard to productivity and quality of his/her tower work, professionalism, and professional growth
• Take on additional responsibilities and demonstrate leadership at a departmental level
• Performs miscellaneous job-related duties as assigned

Position Qualifications

Education:

• Graduate from an accredited medical school
• Preferred completion of an ACGME accredited US residency program

Experience

• Minimum of a total of 5 years of clinical experience including residency

Knowledge, Skills, And Abilities

• Academic Excellence
• Leadership
• Service, compassion, and humanism
• Diversity
• Ability to work as part of a team
• Basic Microsoft Office skills
• Ability to use a PC in a Windows environment, including MS Word, Excel and PowerPoint
• Independent, focused individual able to work remote or on-site

Physical Requirements

The requirements described here are representative of those that must be met by an employee to successfully perform the essential functions of this job with or without reasonable accommodations. Unless otherwise indicated, Accuity Delivery Systems positions require interaction with people and technology while either sitting or standing. Employees must be able to communicate via phone, email, etc. and sit for extended periods of time, with or without reasonable accommodations. Physical effort and exposure to physical risk are limited to that of an office role / environment. While this job description is intended to be an accurate reflection of the job requirements, management reserves the right to modify, add or remove duties from a job and to assign other duties as necessary and at any time. All positions at Accuity are at-will employment, and a position description is not a guarantee of a job or of job responsibilities.