ModusOne Health is a company founded by, managed by, and focused on physicians. The mission of ModusOne is to assist in and monitor the progress of improvement in clinical diagnosis and documentation. ModusOne offers innovative training solutions that empower physicians to work more effectively within any CDI regime. As opposed to query-based systems designed to complete the record in the traditional look-back fashion, ModusOne programs enable clinicians to more accurately identify and concurrently document complications, co-morbidities, and major co-morbidities early in the patient journey. This allows for more complete and accurate documentation of each case as the chart is being written. The net results are physicians that train themselves in the nuances of ICD-10 compliant documentation and hospitals that provide higher quality patient care and produce improved financial performance. Dozens of hospitals around the country have successfully used the ModusOne system to capture tens of millions of dollars in earned, but previously unrealized revenue.
The Medical Director manages and provides clinical guidance for ModusOne’s trademarked Clinical Diagnosis Improvement (or CDxI) system and its related overall documentation improvement (CDI) program, identifying areas of focus for improvement opportunities through the oversight of analysis, interpretation of process and operational reports, financial, compliance, and quality ratings reports. The Medical Director leads operational and clinical client-facing matters including appropriate scheduling and coverage of reviews, query development and auditing, physician education, monitoring the CDI program, and refining the process as needed to clarify documentation records.
Additionally, the Medical Director serves as a resource to client physicians and administrators regarding issues related to the appropriateness of patient assignment and directs the CDxI and CDI team to facilitate documentation within the medical record that supports patient’s severity of illness, screens for undiagnosed co-morbidities, and better outlines risk of morbidity and mortality. The Medical Director must display credibility and strong communication with physicians to make recommendations through appropriate clinical documentation.
- Medical degree (MD/DO) with completed residency.
- Practical understanding of CDI and ICD-10.
- Familiarity with MS-DRGs and the Inpatient Prospective Payment System (IPPS).
- Strong clinical knowledge and demonstrated commitment to maintaining relevancy in clinical field.
- Ability and willingness to communicate with client physicians relating to their daily practice of medicine.
- Demonstrated ability to obtain documentation relevant to denials avoidance related to the Recovery Audit program, the Comprehensive Error Rate Testing (CERT) program, and other audit programs.
- Ability to review medical necessity denials and provide constructive feedback to providers.
- Ability to work with all physician specialties in CDI initiatives, effectively tailoring learning and education opportunities to each physician specialty on an “as you go” basis.
- Attention to detail with ability to be hands-on in the development of clinical content.
- Excellent project management and time management skills.
- Highly productive; addresses problems proactively and meets deadlines.
- Entrepreneurial spirit with interest in being an integral part of a growth phase opportunity.