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Medical Director of Case Management - SSM Health

Employer
SSM Health
Location
Mt. Vernon, IL
Closing date
Feb 24, 2024

View more

Specialty
Other Specialty

Job Details

Presence is exceptional care that delivers exceptional outcomes. We would like to invite you to share that gift as our new Medical Director of Case Management for SSM Health - Southern Illinois Region. We are seeking a well-roundedMedical Director who has the proven ability to engage with their medical staff and hospital leadership and who share our dedication to exceptional care and outcomes.

In addition to being a strong leader and providing support to the Regional Chief Medical Officer for the Southern Illinois Region, the Medical Director will:
  • Provide physician advisory services which directly affects hospital reimbursement, CMI, and other utilization metrics through supporting case management, close relationships with medical staff, communication and knowledge of payer practices, and responsibility for hospital utilization metrics.
  • The ideal candidate will possess strong leadership skills that will play a key role in impacting the rate of observation versus inpatient care.
  • Review referred medical records and addresses the clinical theory of diagnosis for admission status, continued stay and in coordination of written appeal letters to payors.
  • Work with the denials/appeals team in concurrent chart review to assess denials and appropriate levels of care.
  • Daily concurrent chart review as needed by the Case Managers to review current treatment plans, identify unnecessary delays in care, and assist the case managers in facilitating care with the health center and functioning as a liaison to the attending physicians to provide the highest quality of care in the most efficient manner possible.
  • Participates in CDMP program, and addresses any cases referred by the Clinical Documentation Specialists.


Qualifications
  • M.D. or D.O.
  • Hold and maintain an unrestricted medical license in the state of Illinois
  • Meet the requirements (and become a member) of the Hospital medical staff
  • Strong computer skills and working knowledge of the EPIC EMR
  • Must have at least 3 years of clinical experience


To learn more about our organization's Mission, more than 23 hospitals, 11,600+ providers, and 40,000+ team members visit:

http://ssmhealth.com/system

Company

Practice with Presence

More opportunity. More support. More voice. More purpose.

Everything you’ve been looking for is waiting for you at SSM Health, one of the leading health systems in the nation. We believe in the healing power of presence: The better we know our patients as individuals, the better we can care for them.

  • More practice setting locations and options. Our healing ministry features 23 hospitals, more than 290 physician offices and outpatient care sites, and 10 post-acute facilities throughout an integrated system covering Illinois, Missouri, Oklahoma and Wisconsin.
  • More support to help you succeed in your practice.  We partner with our physicians to make sure that they have the technologies, in-network specialists, highly trained staff and infrastructure (such as an Epic® EHR) to allow you to provide best-in-class care for your patients.
  • More voice. Our physicians are the hearts and hands of our system. Here you can contribute to building new programs, expand the reach of our system and contribute to ongoing quality initiatives to help us shape the future of care.
  • More purpose. Our core values and mission unite us to work closely together in a more meaningful way. Through our exceptional health care services, we reveal the healing presence of God.

Discover the difference of practicing with presence at SSM Health.

 

Company info
Website
Telephone
844-776-1400
Location
12312 Olive Blvd
Ste 650
St. Louis
Missouri
63141
US

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