Medical Director for Care Management and Clinical Documentation
4 days ago
About the Role
The Medical Director for Care Management and Clinical Documentation is a critical leadership position at CHRISTUS Health, overseeing the coordination of care and ensuring accurate clinical documentation.
Key Responsibilities:
- Participate in daily IDRs to expedite testing and treatment, promoting efficient patient care and appropriate Level of Care (LOC)
- Provide guidance and assistance to Emergency Department Physicians and Care Management staff to ensure correct LOC designation at intake
- Liaise with payers to facilitate approvals and prevent denials or carved out days when appropriate
- Review cases indicating a need for issuance of a hospital notice of non-coverage determination, discussing the case with the attending physician and assisting with additional clinical information if needed
- Document patient care reviews, decisions, and other pertinent information per hospital policy
- Possess foundational knowledge of InterQual criteria and participate in Care Management Leadership & staff meetings to help identify and progress toward departmental goals
Clinical Expertise:
As a seasoned clinician, you will bring expertise in clinical practice, utilization review, and cost-efficient practices to this role. Certification by the American Board of Quality Assurance and Utilization Review Physicians, Inc (ABQUARP) is preferred.
Education and Experience:
- Licensed physician in the state of residence
- Experience in clinical practice with understanding of utilization review
- Served on or chaired a Utilization Management committee
Earn Up to $175,000 Per Year
With an estimated salary of up to $175,000 per year, depending on experience and qualifications, this position offers a competitive compensation package.
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