Chart Utilization Review Jobs in Washington, DC (NOW HIRING)

It's fun to work in a company where people truly BELIEVE in what they're doing!We're committed to bringing passion and customer focus to the business.SummaryThe Regional Medical Officer is a leadership role reporting to the Regional Operations Director (ROD). The primary responsibility is to ensure providers are well-oriented to PM Pediatric Care’s culture, value and processes; engaged; and well-trained. The Regional Medical Officer will provide training and education for new providers, reinforce skill development among low-performing providers, assist in adjusting the provider schedule to match training needs and seasonality, and address quality and safety concerns.DescriptionKEY FOCUS AREAS• On-time progression of new providers through Provider Training Program• Provider acquisition and retention• Timely scheduling of interviews and candidate hiring decisions• Provider team clinical performance• Building a culture of quality and safetyESSENTIAL RESPONSIBILITIES Provider Training and Ongoing Education for Providers: Provide in-person orientation for new providers, including culture, quality, and office workflow. Ensure timely completion of Provider Training Program, which includes running provider assessments, Bootcamps, skills workshops, lectures, and RESCUE training. Engage early and often with low performing providers to improve their clinical performance and engage all providers in ongoing education, including introducing new clinical guidelines, in collaboration with Clinical Excellence Team. Provider Scheduling and Shift Management: Support ROD in completing and adjusting provider schedule to match training needs and provider productivity. Collaborate with regional team in securing backup coverage for last minute callouts to prevent office closures. Quality, Safety, and Medical Complaints: Respond to patient complaints that are medically related and escalated from the provider who rendered care or calls that are urgent in nature. Review safety reports, investigate root causes, implement corrective actions, and close loop with central teams. Provide feedback to the providers as warranted. Clinical Documentation and Resource Utilization: Ensures appropriate provider documentation, collaborates with Clinical Excellence Team on chart review process; monitors and coaches providers on use of templates, proper coding, and resource utilization. Provider Recruitment and Hiring: Review candidate qualifications, conduct on-site interview, arrange shadowing shifts for candidates, and make timely hiring recommendations to Operations Manager and ROD. Provider Mentorship and Support:Circulate among provider staff at all assigned offices on weekly or bi-weekly basis.Respond to medical escalation consults and/or develop system for peer-to-peer consultConduct pNPS review monthly and, in collaboration with Operations Manager, work with bottom providers on action plan and progress.Recommend to Clinical Excellence Team and Operations Manager any providers in need of Performance Improvement Plans (PIP). Provide training and mentorship related to PIP. Regional support: Provide back up coverage for Regional Clinical Managers or Regional Medical Officers on PTO. Participate in Administrator-On-Call rotation. Physician Officer Duties: Serve as the Clinical Lab Director and Radiography Safety Officer in region. Serve as Collaborating Physician for APPs. Serve as the primary liaison to JV Partners and Chief Medical Officers in region. CLINICAL REQUIREMENT: 26 - 32 hours clinical per week based on regional needs and determined by supervisorCLINICAL REQUIREMENT: 26 - 32 hours clinical per week based on regional needs and determined by supervisorQualificationsMINIMUM HIRING REQUIREMENTS Graduate of an accredited ACGME/AOA in Pediatric or IM-Peds residency training program. BC/BE with the ABP or ABEM/AOBEM. Ability to obtain and maintain DEA certification Licensed in the state where the site is located. Meet threshold criteria/qualifications for Credentialing and Privileges. Training and quality improvement/process improvement experienceATTRIBUTES Recognized by patients and peers as an exemplary pediatric medical provider; sought out by others for advice. Sets and models high performance and behavior standards Pursues everything with energy, drive and a need to finish; meets commitments. Consistently exceeds goals; pushes self and others to excellence.Compensation:$250,000 - $270,000The salary/rate range listed here has been provided to comply with local regulations and represents a potential base salary/rate for this role. Please note that actual salaries/rates may vary within this range above or below, depending on experience and location. We look at compensation for each individual and based on experience and qualifications.EEO StatementPM Pediatric Care is an equal employment opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, sexual orientation, gender identity or expression, national origin, disability status, protected veteran status or any other characteristic protected by law. #J-18808-Ljbffr