Medical Director - Clinical Documentation Integrity

• Position: Medical Director, Inpatient Clinical Documentation Integrity
• Location: Endeavor Health Systemwide role  
• Full Time - 0.75 FTE commitment
• Hours: Monday-Friday, day time hour. Some flexibility required for off-hour coverage
• Required Travel: Yes
• Salary range: [$148.68/hr. -$172.00/hr.]. The pay rate offered is determined within the pay range and is dependent on a variety of factors, including but not limited to FTE, prior experience, certifications, degrees, subspecialties, projected volumes, and quality performance measures

Qualifications:

Minimum Education Level

• Required: MD or DO from an accredited medical school
• Preferred: Additional post-graduate training in quality, management and/or leadership.

Minimum Licensure Requirements Required:

• Required:  MD or DO from an accredited medical school
• Preferred: Additional post-graduate training in quality, management and/or leadership.

Minimum Certification Requirements

• Required:  Active Board certification in a relevant clinical specialty.
• Preferred: Active Physician advisor certification, either from the American College of Physician Advisors certification (ACPA-C) or the ABQAURP Physician Advisor certification (CHCQM-PHYADV), held at hire or achieved within six months of start. 
• CDI-focused certification from AHIMA or ACDIS

Minimum Work Experience

·         Required:  5+ years of post-residency practice and at least 2 years of experience in a physician advisor role with escalating leadership responsibilities in a healthcare setting.  

·         Prior experience in a CDI and physician advisor role and including second-level review, denials, appeals, and clinical validation.

Job Summary

The Medical Director, Inpatient Clinical Documentation Integrity (CDI) is an enterprise role providing physician leadership for the Inpatient CDI program across the entire Endeavor Health system. The position is accountable for a complete and accurate health record that tells the true story of each patient’s clinical condition and the care provided, a critical function that ensures accurate reimbursement, appropriate risk adjustment for quality measures, and the validity of reported quality outcomes. Partnering with CDI operational leaders in a dyad model, this role sets enterprise CDI strategy and serves as the senior physician voice for the program, engaging medical staff, quality, and revenue cycle to advance shared documentation goals across all hospitals. Current scope encompasses acute care CDI system-wide, with accountability for CDI across additional care settings within scope as assigned. The Medical Director of Inpatient CDI embodies Endeavor Health’s values of kindness, teamwork, excellence, and ownership, leading as a collaborative and approachable partner who holds a high bar for the program and takes personal accountability for its outcomes.

This role carries full-system, multi-site responsibility and is a 0.75 FTE commitment and reports to the Vice President of Clinical Documentation Integrity.

Responsibilities and Essential Functions

·         Performs expert second-level and escalation reviews of complex, disputed, or high-impact cases, including clinical validation, query disagreements, and CC/MCC and DRG determinations, serving as the system’s final physician resource for documentation integrity and does so in line with existing Endeavor Health policies and procedures. (20%)

·         Partners with hospital Chief Medical Officers (CMOs), CDI and other physician leaders across the enterprise to drive medical staff education, engagement, and adoption of documentation best practices within their standard templates. (15%)

·         Serves as the subject matter expert and the face of the acute care CDI program to physicians and advanced practice providers, leading enterprise education and providing individualized provider feedback on documentation patterns and query response. (15%)

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·         Maintains the operations of the CDI physician advisor program, including the operating model, relevant workflows and expectations, HR practices, and program reporting. (10%)

·         Leads enterprise CDI physician strategy across all Endeavor Health sites, partnering with CDI operational leaders to set system-wide direction and standardize practice for the care settings within scope. (10%)

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·         Oversees enterprise CDI performance and metrics with operational and entity leaders, supports scorecard target setting, and develops physician advisor and CDI team capability. (10%)

·         Leads the enterprise clinical response to documentation-related audits, denials, and appeals from regulatory bodies and payers, including DRG and clinical validation matters, in collaboration with relevant stakeholders. (10%)

·         Advances education, new technology and organizational process to achieve financial and quality targets, improve physician engagement, and establish and maintain a high performing program. (5%)

·         Promotes ethical, compliant query and documentation practices consistent with AHIMA, ACDIS, AHA Coding Clinic and CMS regulatory standards across the system. (5%)

Knowledge, Skills and Abilities:

• Clinical documentation integrity principles and how a complete and accurate record drives accurate reimbursement, risk adjustment, and quality outcome reporting, including AHA coding clinic guidelines, MS-DRG and APR-DRG assignment, severity of illness, and risk of mortality adjustments, Vizient risk calculators, and others

• Clinical validation, query integrity, and compliant documentation practices consistent with AHIMA and ACDIS standards.
• Healthcare regulations, payer requirements, and revenue integrity practices.
• Performance improvement principles and methodologies, such as the Model for Improvement from the Institute for Healthcare Improvement (IHI)
• Change management principles and methodologies such as Prosci ADKAR® Model.

Skills

• Collaboration and teamwork skills, with a track record of building trust and working effectively across disciplines and hospitals
• Conflict resolution and de-escalation skills, particularly in disputed or high-stakes clinical discussions.
• Strong written and verbal communication skills.
• Analytical and problem-solving skills, with the ability to interpret data and identify trends.
• Leadership and team development skills.
• Organizational and time management skills.

Abilities

•  Leads with kindness and emotional intelligence, fostering a culture of psychological safety and mutual respect.
• Maintains composure, sound judgment, and a steady, professional demeanor in high-pressure or contentious situations.
• Demonstrates a collaborative, approachable presence that engages physicians and teams as partners.
• Sets and upholds a high standard for documentation integrity and program performance, continuously raising the bar.
• Takes personal accountability for program outcomes and follows through on commitments across the enterprise
• Establishes credibility and leadership presence with physicians, executives, and frontline teams across the enterprise.
• Ability to influence and build trust with physicians and stakeholders across clinical and administrative departments.
• Ability to lead and align work across a complex, multi-hospital system.
• Ability to manage multiple priorities in a fast-paced environment.
• Demonstrates professionalism, integrity, and sound judgment, and maintains confidentiality.

Technical Skills:

·         Electronic health record systems, prior work and knowledge of Epic a plus

·         CDI software and computer-assisted coding tools.

·         Data analytics and reporting and visualization tools, including Microsoft Power BI (PBI) and Vizient Clinical Database (CDB)

• Quality Reporting risk adjustment methods, in particular Vizient Risk Adjustment Models

·         Microsoft Office Suite

Benefits:

• Career Pathways to Promote Professional Growth and Development

• Various Medical, Dental, Pet and Vision options

• Free Parking
• Wellness Program Savings Plan
• Health Savings Account Options
• Retirement Options with Company Match
• Paid Time Off and Holiday Pay
• Community Involvement Opportunities

Endeavor Health is a fully integrated healthcare delivery system committed to providing access to quality, vibrant, community-connected care, serving an area of more than 4.2 million residents across six northeast Illinois counties. Our more than 25,000 team members and more than 6,000 physicians aim to deliver transformative patient experiences and expert care close to home across more than 300 ambulatory locations and eight acute care hospitals – Edward (Naperville), Elmhurst, Evanston, Glenbrook (Glenview), Highland Park, Northwest Community (Arlington Heights) Skokie and Swedish (Chicago) – all recognized as Magnet hospitals for nursing excellence. For more information, visit www.endeavorhealth.org. 

When you work for Endeavor Health, you will be part of an organization that encourages its employees to achieve career goals and maximize their professional potential.

Please explore our website (www.endeavorhealth.org) to better understand how Endeavor Health delivers on its mission to “help everyone in our communities be their best”.

Endeavor Health is committed to working with and providing reasonable accommodation to individuals with disabilities. Please refer to the main career page for more information.

Diversity, equity and inclusion is at the core of who we are; being there for our patients and each other with compassion, respect and empathy. We believe that our strength resides in our differences and in connecting our best to provide community-connected healthcare for all.

EOE: Race/Color/Sex/Sexual Orientation/ Gender Identity/Religion/National Origin/Disability/Vets, VEVRRA Federal Contractor.