Director Clinical Documentation Improvement

Overview:
Qualifications: Education
Bachelor's Degree or 4 years clinical documentation work related experience Required

Experience
8 years clinical documentation experience, and Required
5 years Managerial, supervisory or educator experience Required
3 years Coding Experience Required

Licenses and Certifications
Registered Nurse (RN) State And/Or Compact State Licensure Required

Responsibilities: Job Summary
Directs the clinical documentation improvement (CDI) practices to ensure consistency, meet corporate compliance guidelines, and to ensure appropriate and effective reimbursement in cooperation with the following key areas: Utilization Management, Clinical Denials, Health Information Management , Patient Financial Services, Admitting/Registration, Information Services, Laboratory and Radiology and Outpatient Surgery Departments, and HonorHealth Physicians and hospital-based contracted physicians. Establishes operational benchmarks for network wide consistency and best practice standards. Directs the processes and personnel responsible for concurrent review of physician and ancillary documentation to identify opportunities for improved documentation. Directs and participates in process changes throughout the organization. Actively participates in all electronic medical record planning and strategy meetings. Acts as a resource to all other departments and physicians when it relates to documentation improvement.

• Directs and acts as a resource to the personnel assigned as direct reports. Develops clinical data reporting and uses analytical assessment of data, data manipulation, and professionally articulate data outcomes to improve operations and report to various committees, including but not limited to the Utilization Management and Revenue Cycle committees. Actively participates and makes suggestions and recommendations for opportunities to retool and enhance system operations and data management processes. Oversees and works closely with the Physician Advisors, CDI lead, and the CDI Educator to advance clinical documentation improvement functions network wide.
  
• Ensure adequate staffing levels, inclusive of hiring/onboarding, evaluating, managing performance, coaching, and developing employees ensuring employee productivity, quality of work, and alignment of goals with our mission, vision, and values. Plans and develops budgets according to network-wide standards to accomplish critical goals. Monitors variances monthly and takes actions to address targets that are not being met. Ensure compliance with all policies, financial stewardship by being accountable for the financial integrity. Initiates changes in classification, salary action, promotion, demotion, transfer and termination. Resolves employee problems/issues and administers appropriate disciplinary action.
  
• Develop internal key indicator metrics associated with CDI as it related to the revenue cycle and quality outcomes. Maintain goals related to CDI goals. Proactively review clinical documentation. Assures evidence based practices by creating an environment that encourages the use of research and vision in developing and improving operational processes. Develops Network wide policies and procedures for CDI practices to meet Corporate Compliance guidelines and to ensure appropriate and effective reimbursement.
  
• Collaborates with Coding, Denials and Appeals Department in response to documentation denials/appeals on audited claims, documentation initiative, query policies, physician and staff education. Maintains and monitors quality of customer service provided to internal and external customers and medical staff to ensure positive outcomes in response to complaints of inadequate service. Assists the Corporate Compliance Office when issues arise which directly involve CMS, the OIG, and HSAG.
  
• Is a subject matter expert in CDI and can manage multiple areas through collaboration and acts as a coding resource for Physicians and/or hospital-based contracted physicians. Educates clinical documentation nurses on issues related to the government mandated Inpatient Perspective Payment Program (MS-DRGs) and works collaboratively with the coding Director and Supervisors. Assists in setting annual department and individual performance goals for the upcoming year.
  
• Performs other duties as assigned or requested.

Facility: Support Services Department: Clinical Documentation Work Hours: Monday-Friday 8-4:30 PM Shift: 01 - Days Position Type: Regular Full-Time