Director, Medical Documentation

Job Summary

The Director of Medical Documentation provides strategic and operational leadership for sourcing, tracking, and delivering complete medical documentation for approved episodes of care, including initial visit summaries, progress notes, and final visit records, in full compliance with VA contract standards. Reporting to the Vice President of Referral Management, this role oversees medical records and document management functions, develops policies, procedures, and online systems to optimize outcomes, and ensures high performance at both the individual and unit levels. The Director drives efficiency in documentation workflows, manages inventory and productivity goals, and leads interdepartmental and intradepartmental communication and collaboration to strengthen operational integration, service delivery, and staff development.

Education & Experience

Required:

• Bachelor's Degree in Business Administration, Health Care Administration or related field or equivalent experience
• Five or more years of progressively-responsible managerial experience in health care
• Demonstrated experience in medical management, including referral management or utilization management
• Registered Nurse with current unrestricted license in the state in which the successful candidate lives
• U.S. Citizen
• Must be able to receive a favorable Interim and adjudicated final Department of Defense (DoD) background investigation

Preferred:

• Claims processing knowledge
• Medical records or documentation experience
• Knowledge of Military Health System and/or Veterans Administration programs

Key Responsibilities

• Directs all medical documentation activities for the entire organization, with strategy, planning and staffing requirements and activities.
• Develops strategies for achieving TriWest's medical documentation processing goals as well as contract objectives.
• Provides leadership and direction for goals and productivity expectations.
• Develops, implements, and updates medical documentation workflows, policies and desk procedures.
• Reviews audit results and adjusts workflows and other operational procedures.
• Actively participates in cross-functional teams to enhance business strategy, process improvement, and use of industry best practices.
• Provides advanced leadership toward meeting the accreditation needs of the organization.
• Creates annual strategies for performance improvement and develops performance management metrics.
• Manages and supports the administration of the department budget.
• Collaborates with other department leaders to establish and implement performance metrics, goals and policies and procedures.
• Models effective leadership skills to motivate and develop staff.
• Actively participates in the development and implementation of training programs for staff and assists in monitoring the effectiveness of staff training initiatives. • Ensures an effective performance evaluation system is implemented, including appropriate feedback to staff, motivation, and opportunities for growth and development.
• Performs other duties as assigned.
• Regular and reliable attendance is required.

Competencies

Coaching / Training / Mentoring: Actively foster actions required for desired business outcomes through ongoing constructive feedback.

Computer Literacy: Ability to function in a multi-system Microsoft environment using Word, Outlook, TriWest Intranet, the Internet, and department software applications. Ability to gather data and facilitate meaningful analysis.

Empathy / Customer Service: Customer-focused behavior; helping approach, including listening skills, patience, respect, and empathy for another's position.

Independent Thinking / Self-Initiative: Critical thinkers with ability to focus on things which matter most to achieving outcomes; commitment to task to produce outcomes without direction and to find necessary resources.

Information Management: Ability to manage large amounts of complex information easily, communicate clearly, and draw sound conclusions.

Leadership: Successfully manage different styles of employees; provide clear direction and effective coaching.

Organizational Skills: Ability to organize people and tasks and adjust to priorities within time constraints and with available resources; detail-oriented.

Problem Solving / Analysis: Ability to solve problems through systematic analysis of data and processes with sound judgment; realistic understanding of relevant issues.

Team-Building / Team Player: Influence the actions and opinions of others in a positive direction and build group commitment.

Technical Skills: Thorough knowledge of health care delivery, managed care concepts, management reporting tools, and medical management systems; ability to perform critical, in-depth analysis of medical records for appropriateness and effectiveness of referral-activities.

Working Conditions

Working Conditions:

• Works non-regular hours, as required
• Works within an office environment, travel required
• Extensive computer work with prolonged sitting