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Medical Director, Physician Advocate & Case Management Programs

Requisition # 30387 Apply Now

Medical Director, Physician Advocate & Case Management Programs

The Medical Director under the direction of the Vice President of Clinical Transformation and working in partnership with the Vice President of Patient Financial Services, the Academic Department Chairs (or their designees) and the Departments of Medicine and Surgery will have responsibility for the leadership and oversight of the Physician Advocate & Case Management Programs. These programs are designed to promote resource stewardship, to facilitate safe and timely discharge and transitions of care, and to enhance the value of services at CSMC.

This position will have the following detailed responsibilities:
Lead Physician Advocate Program and Contribute to CSMC Strategic Initiatives
• Review and interpret summary level data on hospital performance as compared to benchmarks for length of stay and other utilization metrics
• Participate in utilization review processes to identify opportunities to appropriately decrease the length of stay and length of stay index and ensure appropriate level of care.
• Work collaboratively with members of the Departments of Clinical Transformation, Nursing, Case Management and other members of the High Value Care Committee to:
o Implement methods to optimize utilization of Medical Center services for all patients.
o Safely and efficiently reduce LOS while maintaining patient safety and quality of care.
o Seek to achieve institutional goals for clinical efficiency and appropriateness of care.
• Provide real-time feedback and coaching to attending and consulting physicians regarding appropriateness of care and clinical efficiency, including level of care, discharge planning, progression of care, length of stay, resource utilization, and quality issues.
• Conduct physician education sessions to share data, trends, practice patterns, and other relevant information as requested.
• Collaborate with Clinical Documentation Specialists to ensure that the complexity of patients' conditions and medical decision making is properly documented within allowable standards.
• Provides other services as requested or required.

Supervise Physician Advocates
• Develop and/or update job descriptions for Physician Advocates.
• Recruit, onboard, supervise, and provide mentorship and feedback to the Physician Advocates.
• Support them in their interface with members of the Medical Staff to encourage appropriate utilization of hospital services and to facilitate timely discharge and transitions of care. Act as role model and mentor.
• Support Physician Advocates in identification and implementation of other activities (e.g., monitor appropriate use of continuous cardiac monitoring, Progressive Care Unit, and ICU) to enhance the value of services at CSMC.
• Regularly review the performance of the Physician Advocates, using a variety of methods including direct observation (e.g., attending Progression of Care Rounds), review of performance data, and review of formal and informal feedback from stakeholders.

Serve as Individual Contributor Physician Advocate
• Review patient-specific data and engage with the physician of record, and, if necessary, other physicians involved in the care of the patient to encourage resource stewardship.
• Communicate directly and work closely with treating physicians to address barriers to a timely and safe discharge. Work with physicians to support an appropriate length of stay for each patient and safely discharge when clinical stability is met.
• Participate in multidisciplinary Progression of Care Rounds and discharge planning activities for assigned units and, on a periodic basis, other units to ensure that the Physician Advocate role continues to bring value to that process.

Medical Director to the Case Management and Social Service Departments
• Assist Care Coordinators, Social Workers and Utilization Management RNs to resolve case management issues requiring physician intervention.
• Interface with and educate medical staff on proper patient classification, level of care, quality and compliance with regulatory imperatives.
• Interface with medical staff leadership, attending medical staff, hospital-based physicians and physician trainees in the course of utilization management and case management activities.
• Provide real-time feedback to attending and consulting physicians regarding level of care, documentation of services and resource utilization.
• Provide update reports to the Health Information Committee on utilization management and case management issues.
• Attend hospital meetings to share data, trends, practice patterns and relevant information related to financial and regulatory compliance, medical documentation and utilization management.
• As Co-Director of the Clinical Documentation Improvement Program, work with physicians to improve medical record documentation and properly document patients' clinical conditions.
• Assist with the development and implementation of integrated processes for the functions of care coordination, utilization management and discharge planning.

Qualifications:
• Medical Degree (MD) from accredited medical school required.
• Board Certified in Internal Medicine or General Surgery (or sub-specialty of same) required.
• Candidates must have five (5) or more years of experience as a practicing physician and three (3) or more years of administrative experience improving a hospital/health system's efficiency, effectiveness, quality, and resource utilization (e.g., Utilization Management, Quality Improvement, etc.).
• Candidates must have three (3) or more years of supervising and developing the talents of others and experience in team building.
• Candidate must have demonstrated expertise in EMR systems & efficiency software programs with strong analytical, quantitative and problem-solving skills.
• Candidates must have an appreciation of the needs of full-time faculty physicians and physicians in private or group practice and have the flexibility to meet the needs of both groups.
• Candidates must possess highly developed skills working effectively with a wide variety of stakeholders and constituencies who have strong interests and legitimate requirements.
• Candidates will need to demonstrate a high level of personal confidence, presence and professional demeanor with the ability to build rapport with the Medical Staff and CSMC leadership and to manage through conflicting points of views with stake holder teams during times of change and ambiguity.
• Demonstrated superior interpersonal, communication and presentation skills, in settings from one-on-one to large groups.

STRONGLY DESIRABLE SKILLS/ATTRIBUTES
• Member of good standing in Medical Staff at CSMC.
• Broad knowledge and thorough understanding of the trends and forces shaping health care delivery.
• Demonstrates experience in population health management, clinical decision support, and use of analytics to drive change.
• Demonstrates competence in Continuous Quality Improvement processes including experience in measuring, assessing, and improving services and processes.
• Demonstrates knowledge of the National Patient Safety Goals with the ability to apply each National Patient Safety Goal to his/her own responsibilities.
• Demonstrates knowledge of the Medical Center's Patient Safety program and can describe the Medical Center's Significant Adverse Event process.
• Demonstrates understanding and utilizes the chain of command as it relates to his/her own job.
• Demonstrates understanding of the Medical Center's Culture of Safety and is committed to providing the highest quality patient care measured in high patient satisfaction scores, continuous clinical performance initiatives, excellent medical outcomes, ongoing research, academic programs and national designations and awards.

Medical Director, Physician Advocate & Case Management Programs

The Medical Director under the direction of the Vice President of Clinical Transformation and working in partnership with the Vice President of Patient Financial Services, the Academic Department Chairs (or their designees) and the Departments of Medicine and Surgery will have responsibility for the leadership and oversight of the Physician Advocate & Case Management Programs. These programs are designed to promote resource stewardship, to facilitate safe and timely discharge and transitions of care, and to enhance the value of services at CSMC.

This position will have the following detailed responsibilities:

Lead Physician Advocate Program and Contribute to CSMC Strategic Initiatives

• Review and interpret summary level data on hospital performance as compared to benchmarks for length of stay and other utilization metrics

• Participate in utilization review processes to identify opportunities to appropriately decrease the length of stay and length of stay index and ensure appropriate level of care.

• Work collaboratively with members of the Departments of Clinical Transformation, Nursing, Case Management and other members of the High Value Care Committee to:

o Implement methods to optimize utilization of Medical Center services for all patients.

o Safely and efficiently reduce LOS while maintaining patient safety and quality of care.

o Seek to achieve institutional goals for clinical efficiency and appropriateness of care.

• Provide real-time feedback and coaching to attending and consulting physicians regarding appropriateness of care and clinical efficiency, including level of care, discharge planning, progression of care, length of stay, resource utilization, and quality issues.

• Conduct physician education sessions to share data, trends, practice patterns, and other relevant information as requested.

• Collaborate with Clinical Documentation Specialists to ensure that the complexity of patients' conditions and medical decision making is properly documented within allowable standards.

• Provides other services as requested or required.

Supervise Physician Advocates

• Develop and/or update job descriptions for Physician Advocates.

• Recruit, onboard, supervise, and provide mentorship and feedback to the Physician Advocates.

• Support them in their interface with members of the Medical Staff to encourage appropriate utilization of hospital services and to facilitate timely discharge and transitions of care. Act as role model and mentor.

• Support Physician Advocates in identification and implementation of other activities (e.g., monitor appropriate use of continuous cardiac monitoring, Progressive Care Unit, and ICU) to enhance the value of services at CSMC.

• Regularly review the performance of the Physician Advocates, using a variety of methods including direct observation (e.g., attending Progression of Care Rounds), review of performance data, and review of formal and informal feedback from stakeholders.

Serve as Individual Contributor Physician Advocate

• Review patient-specific data and engage with the physician of record, and, if necessary, other physicians involved in the care of the patient to encourage resource stewardship.

• Communicate directly and work closely with treating physicians to address barriers to a timely and safe discharge. Work with physicians to support an appropriate length of stay for each patient and safely discharge when clinical stability is met.

• Participate in multidisciplinary Progression of Care Rounds and discharge planning activities for assigned units and, on a periodic basis, other units to ensure that the Physician Advocate role continues to bring value to that process.

Medical Director to the Case Management and Social Service Departments

• Assist Care Coordinators, Social Workers and Utilization Management RNs to resolve case management issues requiring physician intervention.

• Interface with and educate medical staff on proper patient classification, level of care, quality and compliance with regulatory imperatives.

• Interface with medical staff leadership, attending medical staff, hospital-based physicians and physician trainees in the course of utilization management and case management activities.

• Provide real-time feedback to attending and consulting physicians regarding level of care, documentation of services and resource utilization.

• Provide update reports to the Health Information Committee on utilization management and case management issues.

• Attend hospital meetings to share data, trends, practice patterns and relevant information related to financial and regulatory compliance, medical documentation and utilization management.

• As Co-Director of the Clinical Documentation Improvement Program, work with physicians to improve medical record documentation and properly document patients' clinical conditions.

• Assist with the development and implementation of integrated processes for the functions of care coordination, utilization management and discharge planning.

Qualifications:

• Medical Degree (MD) from accredited medical school required.

• Board Certified in Internal Medicine or General Surgery (or sub-specialty of same) required.

• Candidates must have five (5) or more years of experience as a practicing physician and three (3) or more years of administrative experience improving a hospital/health system's efficiency, effectiveness, quality, and resource utilization (e.g., Utilization Management, Quality Improvement, etc.).

• Candidates must have three (3) or more years of supervising and developing the talents of others and experience in team building.

• Candidate must have demonstrated expertise in EMR systems & efficiency software programs with strong analytical, quantitative and problem-solving skills.

• Candidates must have an appreciation of the needs of full-time faculty physicians and physicians in private or group practice and have the flexibility to meet the needs of both groups.

• Candidates must possess highly developed skills working effectively with a wide variety of stakeholders and constituencies who have strong interests and legitimate requirements.

• Candidates will need to demonstrate a high level of personal confidence, presence and professional demeanor with the ability to build rapport with the Medical Staff and CSMC leadership and to manage through conflicting points of views with stake holder teams during times of change and ambiguity.

• Demonstrated superior interpersonal, communication and presentation skills, in settings from one-on-one to large groups.

STRONGLY DESIRABLE SKILLS/ATTRIBUTES

• Member of good standing in Medical Staff at CSMC.

• Broad knowledge and thorough understanding of the trends and forces shaping health care delivery.

• Demonstrates experience in population health management, clinical decision support, and use of analytics to drive change.

• Demonstrates competence in Continuous Quality Improvement processes including experience in measuring, assessing, and improving services and processes.

• Demonstrates knowledge of the National Patient Safety Goals with the ability to apply each National Patient Safety Goal to his/her own responsibilities.

• Demonstrates knowledge of the Medical Center's Patient Safety program and can describe the Medical Center's Significant Adverse Event process.

• Demonstrates understanding and utilizes the chain of command as it relates to his/her own job.

• Demonstrates understanding of the Medical Center's Culture of Safety and is committed to providing the highest quality patient care measured in high patient satisfaction scores, continuous clinical performance initiatives, excellent medical outcomes, ongoing research, academic programs and national designations and awards.

  • Working Title: Medical Director, Physician Advocate & Case Management Programs
  • Business Entity: Academic / Research
  • Job Category: Academic / Research
  • Job Specialty: Administrative
  • Position Type: Contingent
  • Shift Type: Day
Apply Now

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