CDQI Physician Advisor
Posted on 3/16/2023
Remote in USA
Experience Level
Desired Skills
  • 3+ years of relevant experience
  • Experience in CDI programs in regional health systems and large academic teaching centers
  • Experience translating broad strategies into specific objectives and initiatives
  • Experience analyzing complex systems and processes, synthesizing relevant theories, principles and evidence and determining solutions challenging problems
  • Experience communicating effectively through various medium and diverse audiences
  • Knowledge of complications, co-morbidities, severity of illness, risk of mortality, case mix index, secondary diagnoses, and the impact of procedures on the final Diagnosis Related Group (DRG)
  • Knowledge of DRG payer issues, documentation opportunities, clinical documentation requirements, and referral policies and procedures
  • Ability to multi-task
  • Experienced computer skills in Microsoft Word, Excel, Office, Outlook, and PowerPoint
  • Conduct clinical reviews on selected service line operating centers and discharges in accordance with the client hospital's objectives for assuring quality patient care and effective and efficient utilization of health care services
  • Interact with medical staff members and medical directors and senior hospital leadership staff
  • Ensure program compliance by following AHA guidelines and coding clinics for coding and required documentation
  • Send complaint queries as endorsed by AHIMA and ACDIS
  • Perform medical record reviews for completeness and accuracy in capturing severity of illness and risk of mortality and queries
  • Determine if professionally recognized standards of quality care are met
  • Provide feedback to attending and consulting physicians regarding level of care, length of stay, and quality issues. Seeks additional clinical information from the attending and consulting physicians
  • Recommend and request additional, more complete, medical record documentation if required
  • Educate specific medical staff departments (e.g., Internal Medicine, Surgery, Family Practice, etc.) at departmental meetings regarding reasons why individual physicians should be concerned about correct disease reporting and the subsequent ICD code capture of severity, acuity, risk of mortality, and DRG assignment, such as: Physician performance profiling, Physician E&M payment and pay for performance
  • Appropriate hospital reimbursement and profiling for patient care
  • Analyze project findings and identify potential root causes of produced errors and prepare education and reference summary reports for clients
  • Oversee and establish relationships as necessary to promote and support interdepartmental workflow
  • Review Medicare and Commercial payer publications frequently and develop coding education proactively to add value to the overall quality of clinical documentation
  • Lead and develop the training and education to hospital CDI staff and physician providers
  • Work directly with the provider(s) as needed to facilitate timely documentation practices and resolution of queries
  • May prepare, document, and conduct all CDQI pre-bill staff performance evaluations including coaching sessions or corrective action plans, as necessary
  • Provide on-going mentorship if needed
  • Assist with special projects as needed and perform related duties as assigned or delegated by management
  • Remain current with coding information to ensure accuracy of codes assigned based on documentation
  • Travel up to 30%
Desired Qualifications
  • You have prior Physician Advisor experience
  • You have acute care experience
  • You have ICD 10 and CPT coding qualifications

51-200 employees

Healthcare data platform
Company Overview
Datavant's mission is to connect the world’s health data to improve patient outcomes.
  • Competitive Salaries & Rewards
  • Generous Parental & Family Leave
  • Ability to work anywhere in the US and Canada
  • Meaningful equity
  • Competitive Benefits – Full Family Coverage
  • WFH Stipend & Monthly Credit
  • Commitment to Learning & Development
  • Unlimited PTO
Company Core Values
  • More Responsibility, Fewer Rules - We have a culture of trust. Every Datavanter has a real project from their first week. Engineers begin checking in code almost immediately.
  • We Grow Leaders - We promote from within to preserve culture and provide unrivaled growth opportunities for our team members.
  • Perfect Is Good, Done Is Better - We move quickly, with a bias towards action.
  • Time Is Our Most Valuable Asset - We prioritize automation and proactively eliminate bottlenecks. And aim to be punctual.
  • Playing To Strengths - As an organization, we only build products and compete in markets where we decisively can win. As team members, we focus on our individual super-powers instead of correcting for weaknesses.
  • Feedback Is A Gift - We proactively provide feedback to our peers and managers in the same warm, open-minded spirit of giving or receiving a gift to a friend. As an organization, we are transparent about both the problems and successes facing the company.
  • We Work Hard - We believe that success requires long hours and is driven more by perspiration than inspiration. We don’t rest on past successes, individually or as a company.
  • Always Pass The “Loved One Test” - You should be proud of the work you do with us, and we won’t make decisions that compromise that.