Business Strategy, Clinical Practices/Protocols, Clinical Study Publications, Communication Skills, Diagnosis-Related Group (DRG), Documentation, Documentation Standards, Electronic Medical Records, Identify Issues, Leadership, Medical Coding, Medical Diagnosis, Medical Treatment, Mentoring, Microsoft Office, Operational Strategy, Patient Care, Performance Metrics, Quality Management, Quality Metrics, Regulatory Compliance, Reimbursement, Retirement Plan, Strategic Planning, Team Player, Trend Analysis, Willing to Travel
The Medical Director is a key clinical leader responsible for driving excellence in documentation integrity and coding accuracy across inpatient care. This role ensures that the complexity and acuity of each patient’s hospital stay are fully captured and reflected in compliant coding practices. By partnering with DRG Validation Auditors, the Medical Director validates diagnoses, procedures, and DRG assignments to optimize quality metrics, reimbursement accuracy, and organizational compliance.
As a strategic advisor and operational leader, the Medical Director influences clinical documentation standards, fosters physician engagement, and leverages data-driven insights to advance organizational goals. This position requires a visionary approach to quality improvement, regulatory compliance, and collaboration across clinical, operational, and technology teams.
Key Responsibilities:
- Clinical Leadership: Provide strategic oversight for documentation and coding integrity, ensuring accurate representation of patient acuity and complexity.
- Collaboration: Partner with DRG Integrity Specialists to confirm principal diagnoses, procedures, and DRG assignments in alignment with official coding guidelines.
- Compliance & Quality: Ensure all documentation and coding practices meet federal regulations, payer requirements, and organizational standards.
- Physician Engagement: Develop and deliver education to providers on documentation best practices and compliance requirements.
- Analytics & Strategy: Review performance metrics, identify trends, and implement initiatives to improve opportunity capture and quality outcomes.
- Innovation: Utilize advanced technology and EMR systems to streamline workflows and enhance accuracy.
- Leadership Development: Mentor team members, foster collaboration, and contribute to organizational growth through strategic initiatives.
Qualifications:
- Education:
- MD or DO degree from an accredited institution.
- Completion of an ACGME-accredited residency program preferred.
- Experience:
- Minimum of 5 years of clinical practice experience, including residency.
- Prior experience in clinical documentation improvement, coding compliance, or revenue integrity preferred.
- Skills & Competencies:
- Strong clinical judgment and expertise in documentation standards.
- Executive-level leadership and strategic thinking.
- Excellent communication and collaboration skills.
- Proficiency in Microsoft Office and EMR navigation.
- Ability to thrive in a dynamic, fast-paced environment.
Job Benefits
- Health insurance
- Vision insurance
- Dental insurance
- Life insurance
- Retirement plan
- Paid time off
Location
- Remote with limited travel to client locations, internal business meetings, and other locations as needed.
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Second Wave Delivery Systems