Hardesty, LLC has been retained to recruit a Regional Chief Medical Advisor (RCMA) for a healthcare system client based in Southern California. The position will be responsible for the hospital region in Inland Empire. Ideally, the individual will have experience with utilization management, understand the state and federal regulations, have knowledge about the denials and appeals process, have experience with physician documentation and electronic health records, and be willing to be a part in physician education. The position will report to the Corporate Chief Medical Officer.

In addition to the principal duties and responsibilities of the Regional Medical Director, the position will also be required to address the following immediate organizational needs:

• Improve health record documentation that specifically affect Clinical Documentation Improvement (CDI) code assignment capture of severity, acuity, risk of mortality, and DRG assignment.
• Educate hospital staff physicians about CDI coding guidelines (e.g., co-morbid conditions, outpatient vs. inpatient) and clinical terminology to improve their understanding of severity, acuity, risk of mortality, and DRG assignments on their individual patient records.
• Act as a liaison between the CDI professional, HIM, and the hospital’s medical staff to facilitate accurate and complete documentation.
• Work with hospital case management team to achieve appropriate patient length of stay benchmarks.

Minimum Qualifications Education:

• Graduate of an accredited medical school.
• Additional education in quality and utilization management through continuing medical education programs and self-study.

Experience:

• Minimum of 3 years recent experience in clinical practice.
• Utilization management experience as a member of the UM oversight committee or past physician advisor experience preferred.

Licensure:

• Licensed physician

If you are interested in this position or know of an executive who is the right fit, please contact us or forward your resume to: Michael Low, at mlow@hardestyllc.com.