Documentation & Utilization Excellence – Medical Director Opportunity
Saint Alphonsus Medical Group (SAMG) has an excellent Medical Director opportunity for an experienced physician to join Saint Alphonsus Health System located in Boise, Idaho.
The Medical Director of Documentation and Utilization Excellence (MDUE) is the lead provider for coordination and oversight of both utilization management efforts and documentation excellence initiatives. The MDUE will have an established record of clinical excellence and credibility. Will be familiar with hospital medicine and principles of proper utilization and appropriate clinical documentation. The MDUE will work in a dyad partnership with the SAHS Director, Clinical Resource Management.
This is a full-time opportunity and requires a 0.7-.8 FTE Administrative / 0.2 – 0.3 Clinical commitment. The schedule for this opportunity is Monday through Friday 8:00 a.m. to 5:00 p.m. There is no call associated with this opportunity.
- Consistently emulates the SAHS mission and guiding behaviors.
- Perform Physician Advisor role in determining and arbitrating level of care determinations performing Peer-to-Peer reviews with insurance companies who are denying an inpatient level of care. Complement current physician advisor efforts at completion of second level reviews for patients not meeting inpatient criteria.
- Participates in local Utilization Review Committee and be a member of appropriate committees and teams to improve utilization, care transitions and appropriate clinical documentation as assigned.
- Engage in physician-to-physician communication to provide just-in-time education and resolve conflicts regarding utilization concerns and clinical documentation excellence education.
- Conduct rounds to monitor compliance with developed policies and procedures for bed placement, accurate reporting of bed status.
- Assist case managers, utilization review nurses and social workers to overcome barriers as they identify patients ready for transfer or discharge.
- Participate as needed in forums to manage day-to-day bed management issues, especially during times of HVM (high volume management) including treat & transfer discussion and decisions.
- Arbitrate admission and discharge decision made by other physicians as deemed appropriate.
- Refer individuals to the appropriate chain of command who demonstrate patterns of physician behavior that impede the throughput process.
- Assist as requested in the role out of EMR initiatives.
- Lead Health Grades and other clinical initiatives that rely heavily on excellence in clinical documentation.
- Communicates using multiple methods with their constituency.
- Attends required meetings as determined.
- Feels comfortable providing in person communication and presentation in front of large groups.
- Is able to maintain timely email communication with colleagues.
- In collaboration with SAHS administration, helps oversee and provide mentorship to hospital based providers regarding utilization and clinical documentation.
IV. Quality and Risk.
- In collaboration with the SAHS administration, risk and legal teams, assures that medical utilization and documentation programs are compliant with legal and regulatory requirements.
- Participates in peer review activities as requested.
- Identifies human resource, compliance and risk management issues, reports those risks to SAHS leadership and/or SAHS Office of the General Council, or the SAHS Compliance Officer as appropriate.
Requirements for this opportunity include:
- Requires all skills, knowledge, education, licensing, certification, experience and essential functions to function in the role.
- M.D / D.O. degree required.
- A minimum of two years' experience in hospital based medicine with exposure to utilization management and documentation initiatives.
- Demonstrated teamwork, performance analysis, presentation, interpersonal, facilitation, planning, and communication skills.
- Ability to build and maintain positive rapport with dyad partner, SAHS leadership, peers, physicians and staff.
- Ability to work with Trinity Health experts in managing and developing medical utilization programs and documentation initiatives.
An excellent compensation and benefits package is available for the right candidate including:
- Sign-on Incentives
- Student Loan Repayment
- PTO & CME Allocation
- Malpractice Insurance (Incl. Tail)
- Retirement (403b)
Saint Alphonsus Regional Medical Center is a 387 bed regional medical center serving people throughout the Northwest and is the principal provider of advanced, innovative and interdisciplinary services. It is also the region's only ACS verified Level II Trauma Center whose annual trauma volumes exceed 1,700 with over 400 patients with an ISS>16. Trauma is predominantly blunt in nature. There are a wide range of subspecialty services available 24/7, including strong trauma/surgical critical care, neurosurgical coverage, in-house interventional radiologists, vascular surgeons, cardiothoracic surgeons and fellowship trained intensivists and cardiologists.
As a not-for-profit medical center, Saint Alphonsus reinvests profits back into the community and works to improve the health and well-being of those we serve by emphasizing care that is patient-centered, innovative and community based. It focuses on providing services in a spiritual, healing environment; is renowned for its state-of-the-art digital environment and pioneering technologies including advanced imaging capabilities; and is known for its award-winning clinical services.
On January 15, 2013, HealthGrades® 11th annual Hospital Quality and Clinical Excellence Study again named Saint Alphonsus a Distinguished Hospital for Clinical Excellence™ for the third year in a row. Saint Alphonsus is the only hospital in Idaho to receive this recognition five times since the award originated in 2003 (2003, 2006, 2011, 2012 and 2013). This prestigious distinction places our medical center among the Top 5% of hospitals nationwide for clinical performance.
The medical center is part of Saint Alphonsus Health System, a growing four-hospital, 714-bed integrated healthcare system serving the full range of the health and wellness needs of the people in southwestern Idaho, eastern Oregon and northern Nevada. The system is comprised of Saint Alphonsus Regional Medical Center in Boise, Idaho, Saint Alphonsus Medical Center in Nampa, Idaho, Saint Alphonsus Medical Center in Ontario, Oregon and Saint Alphonsus Medical Center in Baker City, Oregon. Saint Alphonsus Health System is a member of Trinity Health, the second largest Catholic Health System in the nation. Trinity Health is based in Livonia, Michigan.
For more information about Saint Alphonsus Health System, http://www.saintalphonsus.org/
Caldwell, Idaho with an estimated population of 47,700 is a city in and the county seat of Canyon County in southwestern Idaho. Caldwell is considered part of the Boise metropolitan area and it along with the cities of Boise, Nampa, Meridian, Eagle, Star, Emmett, Garden City, Kuna and Mountain Home comprise the Boise Valley (aka the Treasure Valley). Located along Interstate 84, it is 35 minutes from the Boise Airport.
For more information on Caldwell, visit www.cityofcaldwell.com/
Boise, Idaho, is an economically vibrant and growing community. Boise is a mid-sized metropolitan area of approximately 640,000 people. A commercial center in the Northwest, Boise is an outdoor enthusiast’s paradise and a flourishing scene for arts, entertainment and collegiate and professional sports. Known as the “City of Trees,” Boise also offers a reasonable cost of living, low crime rate, excellent cultural programs, numerous neighborhood parks and nearby national forests and rivers. Idaho's culture of physician independence also makes it one of the best places in America to be a practicing physician.
Several high-profile publications rank the Boise metro area as one of the best places in the country to do business and live.
- Outside Magazine recently said, “The winner for best overall town in the western U.S. is Boise, Idaho.”
- Forbes recently ranked the Boise metro area 2nd for raising a family; particularly noting its low crime and high school quality, not to mention the chance to mix urban and outdoor lifestyles.
- CNN/Money ranks the Boise metro area 3rd best place to retire and also named Idaho as the friendliest state for small businesses.
- Medscape Medical News identifies Boise and Idaho as the Best City and State to practice medicine in the West & Northwest Region of the U.S.
For many, work life in Boise is characterized by diverse industries, like technology, government and financial services. Boise is headquarters for several major companies and manufacturing facilities. The corporate community includes Fortune 500 members: Hewlett Packard, Boise Cascade, Washington Group International and Micron Technology. Leading employers also include state government, universities, regional health centers and high tech companies.
When it comes to enjoyment, there are many ways to play in Boise. Situated where the high desert meets the western edge of the Rocky Mountains, Boise is the gateway to exceptional recreational opportunities including: world famous white-water rafting, Nordic and Alpine skiing, snowboarding, hunting, fishing, backpacking, hiking, biking, and camping. A charming downtown area delights residents with fine dining, theater, dance clubs and live music. Summer nights are spent taking in performances at the Idaho Shakespeare Festival or enjoying outdoor live concerts at the Idaho Center. A regional hub for jazz and theater, and home to The Boise Center which hosts numerous functions throughout the year, Boise is a delightful blend of traditional and non-traditional sights and attractions.
Boise frequently receives national recognition for its quality of life and business climate. Recent national rankings include: Best places for business and careers as well as Most Secure Place to Live (500,000 or more residents). Boise and the surrounding communities afford a quality of life second to none. Offering good jobs, affordable housing, a safe, clean and vibrant downtown, and with its vision of becoming the Most Livable City in the Country, the Boise area is a great place to live, work, and raise a family.
For more information on Boise, please visit www.boise.org
Trinity Health is one of the largest multi-institutional Catholic health care delivery systems in the nation. We serve people and communities in 22 states from coast to coast with more than 90 hospitals and 100 continuing care facilities – including home care, hospice, PACE and senior living facilities and programs that provide nearly two and a half million visits annually. Trinity Health employs more than 133,000 colleagues, including 7,800 employed physicians and clinicians.
Our mission: We, Trinity Health, serve together in the spirit of the Gospel as a compassionate and transforming healing presence within our communities. We support this mission by living our core values of Reverence, Commitment to Those Who are Poor, Justice, Stewardship, and Integrity. Committed to recruiting talented physicians, we are looking for physicians who share our values and want to help us fulfill the health care needs of the communities we serve.
At Trinity Health, we value the physician relationship and focus on partnering with our physicians. Whether you are a practicing physician looking to relocate or a medical resident, we offer opportunities with the flexibility to fit your individual needs. If you would like to be part of Trinity Health, we encourage you to explore this opportunity at www.trinity-health.org.
If you are interested in this opportunity and would like to submit your CV, please email firstname.lastname@example.org or call Trinity Health Physician Recruitment at (734) 343-2300.