Manager Clinical Documentation - Clinical Doc Mgmt Program - Full Time

Job Description

Position Summary:

Manages the day‐to‐day operations of the Clinical Documentation Integrity team and tracks and trends program compliance, along with oversight of the team of Registered Nurses. Provides leadership to promote effective and efficient review of physician documentation to support the patient's level of care and appropriate assigning of DRG's and develop action plans for improvement. The Clinical Documentation Integrity Manager is responsible for improving the overall quality and completeness of clinical documentation by collaborating with physicians, nursing staff, other patient caregivers, and medical records coding staff to ensure that clinical documentation accurately reflects the level of service rendered to patients and the accuracy and completeness of clinical information used for measuring and reporting physician and medical center outcomes. Educates members of the health care team on an ongoing basis, including new CDI staff, providers, and other healthcare professionals.

Education, License & Cert:

RN Or CCDS Certification Required. Master’s Preferred.

Experience:

Prior CDI experience required. Registered Nurse with minimum of 5 years clinical experience in an acute care setting required. Recent management or supervisory experience preferred. Advanced clinical expertise and extensive knowledge of complex disease processes with broad based clinical experience in an inpatient setting. Critical care, utilization review or coding experience desired. Requires excellent communication (verbal, written & electronic) and problem‐solving skills. Detail oriented with exceptional analytical/critical thinking.

Essential Functions:

• Facilitates modifications to clinical documentation for designated patients to ensure that documentation reflects the level of services rendered which supports proper coding, billing and reimbursement and quality of care outcomes.
• Accountable for meeting and managing departmental goals and budgets. Negotiates for budgetary dollars FTE's necessary to support business initiatives for Clinical Documentation Integrity Department's future growth when needed. Works closely with Finance to develop and update forecasting departmental budget.
• Manages employees by providing feedback, recognition, counseling, and discipline on an individual basis as indicated by the needs of each employee. Coordinates orientation of new employees. Arranges education and training for staff within the department based on identified opportunities to improve performance.
• Recognizes and attracts high potential talent. Sets and clarifies performance expectations with employees and promotes ongoing feedback on a regular basis. Completes employee performance appraisals according to defined policy and procedures. Mediates individual employee issues or problems and consults Director of Care Coordination on unresolved situations.
• Demonstrated ability to provide leadership and direction to Clinical Documentation Integrity Department Staff and coding specialists with relation to Clinical Documentation issues. Possesses a broad knowledge of insurance regulations and Medicare guidelines. Knowledge of organizational policies and procedures.
• Proficient in computer usage, especially database and spreadsheet analysis. Must possess skills required to run a fiscally responsible program while ensuring constant improvement. Skill in identifying problems and recommending solutions. Skill in preparing and maintaining records and written reports. Skill in establishing and maintaining effective working relationships with physicians, hospital staff and vendors.
• Maintain knowledge of system software, implement enhancements and modifications to promote system capability, user efficiency, regulatory agency requirements, and reporting needs.
• Ability to interpret, adapt, and apply guidelines and procedures. Ability to analyze complex clinical scenarios and apply critical thinking. Extensive knowledge of treatment methodology, patient care assessment, data collection techniques and coding classification systems is necessary. Serve as a resource on DRG issues.
• Extensive knowledge of reimbursement systems. Extensive knowledge of federal, state, and payor‐specific regulations and policies pertaining to documentation and coding. Joint oversight of DRG reassignment denials with HIM IP Coding Manager.
• Ability to contribute to the development and implementation of strategic planning processes, day‐to‐day operations, and attainment of organizational and departmental goals. Provide clinical and administrative leadership and expertise; facilitates an atmosphere of interactive management and the development of collegial relationships among all team members.
• May lead, facilitate and implement system CDI process improvement and development.
  
  
  

Other Duties:

• Participates on departmental/hospital committees and taskforces.
• Ability to travel to other Guthrie entities as needed.
• It is understood that this description is not intended to be all inclusive, and that other duties may be assigned as necessary in the performance of this position.