Clinical Condition Documentation Supervisor

POSITION DESCRIPTION:

The Clinical Condition Documentation (CCD) Supervisor is responsible for overseeing the staff that provides risk adjustment coding support as part of the CCD team and ensuring accurate and efficient documentation and diagnosis coding utilizing the CMS Hierarchical Condition Category (HCC) model and M.E.A.T (Monitored, Evaluated, Assessed/Addressed, or Treated) standards. The CCD Supervisor will assist in project management support within the Quality and Population Health Department with a focus on projects supporting Clinical Condition Documentation and Risk Adjustment. This position manages the Certified Risk Adjustment Coder activities to support the Trinity Health Michigan Medical Groups. In addition to the supervisory responsibilities, the CCD Supervisor will continue to function as a CCD Specialist.

ESSENTIAL JOB FUNCTIONS:

This position performs all Essential Functions in the Clinical Condition Documentation Specialist job description, as well as the following Clinical Condition Documentation Supervisor Essential Functions outlined below.

Leadership Responsibilities:

1. Serves as a CCD subject matter expert for Trinity Health Michigan Medical Group’s Clinical Condition Documentation program and coordinates work across a team of Certified Risk Adjustment coders.
2. In collaboration with the Associate Director – CCD, uses advanced analytical skills and strategic thinking to organize, plan and coordinate clinical activities in relation to clinical condition documentation and participate in the development of long-range plans for Trinity Health Michigan Medical Groups.
3. Leads the development and dissemination of reporting to drive the identification of key performance metrics and tracks success for the Certified Risk Adjustment Coders.
4. Works closely with physician champions as well as Medical Group and Division Leadership to develop education materials to ensure providers have the knowledge and resources to validate all chronic conditions during each patient's visit.
5. Attends payer update meetings (Blue Cross, Priority Health, HAP, etc.) as required.  Shares information back with appropriate departments.
6. Presents topics and initiatives to a variety of groups as needed.
7. Supports clinical condition documentation across multiple divisions, attends required meetings and training, and participates in committees as requested.
8. Performs other duties as assigned.

Management Responsibilities:

1. Supervises the work of assigned staff, including the monitoring of staff competencies, hiring of new staff, orientation of new assignments, developing goals and objectives, conducting annual performance appraisal/merit consideration and the utilization of performance resolution process when needed.
2. Creates an effective, participative management environment with a special emphasis on team building across the continuum, integrating clinical condition documentation in population health management.
3. Assists with recruitment, hiring, orientation, training and coaching of assigned staff, in accordance with IHA service and Human Resource guidelines. Effectively organizes training materials for new employees.
4. Collates and distributes departmental meeting agendas and minutes as requested.

Compliance Responsibilities:

1. Assures all areas of responsibility are compliant with federal, state and safety regulations; reviews reports and information provided by the Director of Compliance and Risk to ensure that each area maintains a documentation and audit program; assures that leadership within each area develops relevant plans to address any quality or patient safety issues.

ORGANIZATIONAL EXPECTATIONS:

1. Creates a positive, professional, service-oriented work environment for staff, patients and family members by supporting the mission and values of Trinity Health Medical Group.
2. Must be able to work effectively as a member of the Quality & Population Health team.
3. Assumes responsibility for performance of job duties in the safest possible manner, to assure personal safety and that of coworkers, and to report all preventable hazards and unsafe practices immediately to management.
4. Successfully completes all relevant organizational training and adheres to Trinity Health Medical Group standard of care as outlined in the Trinity Health Code of Conduct.
5. Maintains knowledge of and complies with Trinity Health Medical Group standards, policies and procedures.
6. Maintains general knowledge of Trinity Health Medical Group  office services and in the use of all relevant office equipment, computer and manual systems.
7. Maintains strict confidentiality in compliance with Trinity Health Medical Group  and HIPAA guidelines.
8. Serves as a role model by demonstrating exceptional ability and willingness to take on new and additional responsibilities.  Embraces new ideas and respects cultural differences.
9. Uses resources efficiently.
10. If applicable, responsible for ongoing professional development – maintains appropriate licensure/certification and continuing education credentials, participates in available learning opportunities.

MEASURED BY:

Performance that meets or exceeds IHA CARES Values expectation as outlined in IHA Performance Review document, relative to position.

ESSENTIAL QUALIFICATIONS:

EDUCATION: Associate’s or Bachelor’s degree in business or health care or an equivalent combination of education and experience.

CREDENTIALS/LICENSURE: AAPC CRC certification required.

MINIMUM EXPERIENCE: 5-7 years’ experience in the healthcare industry with 2-3 years’ experience in risk adjustment coding preferred. Supervisory or leadership experience preferred.

POSITION REQUIREMENTS (ABILITIES & SKILLS):

1. Knowledge of industry-appropriate terms generally used in clinical condition documentation.
2. Maintains complete knowledge with all diagnosis coding guidelines.
3. Proficient at data analysis.
4. Ability to support projects with general direction with a moderate degree of ambiguity.
5. Ability to support multiple projects simultaneously.
6. Excellent communication skills in both written and verbal forms, including proper phone etiquette.  Ability to write understandable and unambiguous projects.
7. Ability to facilitate a group discussion and effectively manage meetings. Ability to speak before groups of people, either in-person or virtually. 
8. Good organizational and time management skills to effectively juggle multiple priorities, time constraints and health care industry changes.
9. Demonstrated ability to exercise sound judgement, trouble-shooting and problem-solving skills, i.e., identifying complex problems, reviewing options, and making appropriate recommendations based on the business case presented.
10. High-level of proficiency in operating a standard desktop and Windows-based computer system, including but not limited to, electronic medical records/templates (e.g., Epic), Microsoft Office (Excel, Access, Outlook, Word, PowerPoint), email, e-learning, intranet and computer navigation. Ability to use other software as required while performing the essential functions of the job. Ability to work with new applications, including vendor software, understanding of terminology and processes utilized to enhance and maintain reporting.
11. Ability to work independently and collaboratively in a team-oriented environment as a member of the Population Health team. Possesses courteous and friendly demeanor.
12. Ability to work effectively with various levels of organizational members and diverse populations including IHA staff and management, senior management group, site medical directors, division heads, providers, patients, family members, outside customers, vendors, hospitals, and community groups.
13. Ability to cross-train in other areas of practice/department to achieve smooth flow of all operations.
14. Ability to perform mathematical calculations needed during the course of performing basic job duties.
15. Knowledge of the compliance aspects of clinical care, patient privacy, and best practices in medical office operations.
16. Willing to gain an overall understanding of IHA structure and workflow processes throughout the organization and ability to provide analytic support for the company structure.
17. Ability to handle patient and organizational information in a confidential manner.
18. Ability to drive to other office/practice sites and meeting and training locations.
19. Successful completion of IHA competency-based program within introductory and training period. 

MINIMUM PHYSICAL EXPECTATIONS:

1. Physical activity that often requires keyboarding, phone work and charting.
2. Physical activity that often requires time working on a computer.
3. Physical activity that occasionally requires lifting up to 20 lbs.
4. Specific vision abilities required include close vision, depth perception, color vision, peripheral vision and the ability to adjust and focus. 
5. Manual dexterity sufficient to operate a keyboard, photocopier, telephone, calculator and other office equipment.
6. Must hear and speak well enough to conduct business over the telephone or face to face for long periods of time in English.

MINIMUM ENVIRONMENTAL EXPECTATIONS:

This job operates in both an office environment and in a medical facility. It involves frequent interruption, competing priorities and significant interaction with people which can be stressful at times and result in competing priorities. Employees may be working where there is patient care equipment. Hazardous materials, including bloodborne pathogens and bodily fluids are also present.