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  • CDI Physician Advisor

    Penn Medicine (Philadelphia, PA)



    Apply Now

    Description

    Penn Medicine is dedicated to our tripartite mission of providing the highest level of care to patients, conducting innovative research, and educating future leaders in the field of medicine. Working for this leading academic medical center means collaboration with top clinical, technical and business professionals across all disciplines.

     

    Today at Penn Medicine, someone will make a breakthrough. Someone will heal a heart, deliver hopeful news, and give comfort and reassurance. Our employees shape our future each day. Are you living your life's work?

     

    Entity: Corporate Services

     

    Department: Corporate HIM Administration

     

    Hours: M-F, 8hr days, hybrid

    Summary:

    + The CDI Physician Advisor is a key member of the healthcare organization's leadership team and is charged with meeting the organization's goals and objectives for ensuring the accuracy, completeness, and integrity of clinical documentation to reflect the true severity of illness (SOI), risk of mortality (ROM), and quality of care provided. This role is primarily administrative (approximately 80%) with a clinical component (approximately 20%).The CDI Physician Advisor will act as a resource and liaison between our clinical staff, CDI Team, coding professionals, and hospital leadership. Serving our health system, this individual will champion the principles of comprehensive and precise clinical documentation. The primary focus will be to collaborate with medical staff to improve documentation practices to improve the capture of severity of illness (SOI), risk of mortality (ROM), and the overall complexity of patient care, ensuring that the medical record accurately reflects the patient's condition and the high-quality care provided at Penn Medicine.This role is ideal for a physician leader passionate about clinical quality, education, quality improvement, and the integrity of clinical data in a leading academic health system.This role will bridge the gap between the clinical and revenue cycle work streams by connecting clinicians, revenue cycle staff and digital teams, translating between roles to have the same goal of providing the best experience for our patients and clinical teams. The CDI Physician Advisor should be appointed to guide physician governance, alignment and training. They should be designated to represent the perspective of medical staff across the organization, act as the key champion for the clinical components and work closely with the designated CDI program leader to ensure clinical aspects of CDIP are met in order to realize project success for the system. They will also promote understanding of how documentation impacts quality metrics and reimbursement and foster trust and credibility with medical staff to encourage buy-in.The CDI Physician Advisor shall possess and/or develop expertise on matters regarding physician practice patterns, CDI, Coding, medical necessity, levels of care, care progression, denial management, compliance with governmental and private payer regulations, and appropriate physician documentation requirements.The CDI Physician Advisor role will report to the Senior Director of Health Information Management with a dotted line reporting structure to the Chief Health Informatics Officer, the CDI Physician Advisor works closely with medical staff leadership, medical staff, and all areas of clinical documentation improvement, CEQI, denials management, coding, utilization management to develop and implement methods to optimize the use of hospital services.

    Responsibilities:

    + Provide education to specific providers and medical departments regarding the significance of complete and accurate disease reporting for physician performance profiling, pay-for-performance, and appropriate profiling for patient care and reimbursement

    + Conducts concurrent and retrospective reviews of inpatient medical records to identify opportunities for improving the clarity, consistency, and specificity of clinical documentation.

    + Analyze CDI metrics such as case mix index, severity of illness, and length of stay

    + Communicate feedback on program results and physician score cards to executive leadership and physician community

    + Liaison between the CDI department, medical staff, and medical executives to encourage physician cooperation for comprehensive and precise clinical documentation

    + Facilitate physician related issues, query escalation plan, and acting as a resource to CDI with regards to physician related challenges

    + Attend and actively participate with CMO meetings and provide CDI data

    + Build stronger relationships between clinical, financial, and digital teams to help with competing priorities.

    + Regulatory & Compliance Support- Maintain compliance with Medicare rules and regulations. Ensure documentation aligns with regulatory requirements and payer expectations. Help mitigate risks related to audits and litigation through accurate documentation

    + Stay current on changes in payer rules as it pertains to clinical documentation

    + Collaborates with subspecialty providers to create consistent definitions and documentation around complex conditions

    + Prioritize operational efficiency and dedication to understanding impacts to clinical workflows

    + Provide feedback to Contracting on payer denial patterns relating to clinical documentation where appropriate

    + Facilitate, mentor, and educate providers, CDI, HIM Coding regarding documentation and payer requirements

    + Performs duties in accordance with Penn Medicine and entity values, policies, and procedures

    + Other duties as assigned to support the unit, department, entity, and health system organization

    Credentials:

    + Must be a PA State Licensed Medical Doctor or Doctor of Osteopathic Medicine. (Required)

    Education or Equivalent Experience:

    + MD or DOEquivalent Experience. (Required)

    + 5+ years of clinical experience in a hospital setting. (Required)

    + 3+ years of experience as a medical director or similar role in a healthcare system with experience in documentation optimization, coding education, and denials management. (Required)

    + 3+ years of knowledge of information technology, including statistical analysis, medical informatics and electronic medical record documentation, clinical protocols, guidelines, case management programs, and outcome measure assessments. (Required)

    + Possess and maintain an unrestricted medical license in the State of Pennsylvania. (Required)

     

    We believe that the best care for our patients starts with the best care for our employees. Our employee benefits programs help our employees get healthy and stay healthy. We offer a comprehensive compensation and benefits program that includes one of the finest prepaid tuition assistance programs in the region. Penn Medicine employees are actively engaged and committed to our mission. Together we will continue to make medical advances that help people live longer, healthier lives.

     

    Live Your Life's Work

     

    We are an Equal Opportunity employer. Candidates are considered for employment without regard to race, ethnicity, color, sex, sexual orientation, gender identity, religion, national origin, ancestry, age, disability, marital status, familial status, genetic information, domestic or sexual violence victim status, citizenship status, military status, status as a protected veteran or any other status protected by applicable law.

    REQNUMBER: 285891



    Apply Now



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