JOB SUMMARY

Manages activities of the Clinical Documentation Improvement department locally and/or across other Conifer’s CDI departments. Lead the monitoring of performance, collection, and analysis of data to report on the effectiveness of process improvement. Collects and analyzes data to provide reports for company and hospital wide use and to make recommendations as appropriate. Will participate in the planning, development and implementation, and ongoing success of the Clinical Documentation Management Program. Educates members of the patient care team regarding documentation guidelines, including attending physicians, nursing, and other interdisciplinary team members.

KNOWLEDGE, SKILLS, ABILITIES

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

• CDI Subject Matter Expert
• Knowledge of Medicare Part A and familiar with Medicare Part B
• Knowledge of disease pathophysiology and drug utilization
• Knowledge of MS-DRG classification and reimbursement structures
• PC/Systems literate including the Internet and MS office skills
• Ability to apply coding conventions, official guidelines, and Coding Clinic advice to health record documentation
• Management of multiple priorities – effective time management skills
• Leadership and organizational skills along with critical, deductive reasoning and problem solving skills
• Effective written and verbal communication skills including report writing and presentation skills
• Capacity to work independently in a virtual office setting or at facility setting if required to travel for assignment.
• Understand and communicate documentation strategies
• Recognize opportunities for documentation improvement
• Formulate clinically, compliant credible queries
• Ability to maintain an auditing and monitoring program as a means to measure query process
• Report writing with management review
• Skilled in performing quality assessment/analysis
• Overall knowledge and ability to drive operational metrics.
• Overall knowledge of the flow of the revenue cycle
• Detail oriented and analytical skills
• Assess, coach, train and develop talent
• Possesses the ability to motivate and maintain effective working relationships with staff and all stakeholders.
• Demonstrates strength in both performance management and leadership development
• Manage change while minimizing interruption at an operational and service level

EDUCATION / EXPERIENCE

Include minimum education, technical training, and/or experience required to perform the job.

• Three (3) or more years’ experience in CDI
• Preferred: Graduate from a Nursing program, BSN or graduate of Health Information Management RHIT, RHIA
• Preferred: Minimum: Two (2) years supervisory experience

ESSENTIAL DUTIES AND RESPONSIBILITIES

Include the following. Others may be assigned.

• Monitoring and Building CDI team
• Oversee and act as resource for Clinical Documentation Improvement departments across Conifer Health including monitoring daily activity and completion of performance and metric reports.
• Test, interview, hire and retain CDI staff.
• Lead meetings with team leads and CDI l staff Account for timekeeping in all systems for all initiatives
• Development of team goals and plans ensuring alignment with national goals and yearly evaluations
• Improve Medical CMI throughout Conifer.
• Responsible for the supervision and coordination of CDI process including implementation and adherence to best practices and principles.
• Education/Development/Communication
• Educates department and facility staff as needed.
• Develops of facility specific Policy &Procedure, process flow maps, communication and education plans in line with national directives
• Lead meetings and educate within Systems and Individual facility leaders including Presidents, CMO, CFO, Facility Physician Service Line Heads, Physicians and other leaders.
• Communicates/Completes Clinical Documentation Improvement (CDI) activities and coding issues (lacking documentation, physician queries, etc.) for appropriate follow-up and resolution.
• Develops a collaborative CDI and Coding team.
• Analysis/Implementation:
• Performs analysis, identifies trends, validation of compliance as related to the clarity of documentation which impact revenue.
• Market analysis and interpretation of regional and facility-specific data and CDI audits.
• Implement and develop new CDI programs across the markets.
• Professional Development:
• Stays current with AHA Official Coding and Reporting Guidelines, CMS and other agency directives for ICD-9-CM. Attends mandatory coding seminars on annual basis (IPPS and OPPS, ICD-9-CM and CPT updates) for inpatient.
• Quarterly review of AHA Coding Clinic. Attends Quarterly Coding Updates and all coding conference calls as well as any required CDI education.
• CDI leader for ICD 10 impact – ICD10 Core team and education leader of CDI staff
• Other duties as assigned

SUPERVISORY RESPONSIBILITIES

If direct report positions are listed below, the following responsibilities will be performed in accordance with guidelines, policies and procedures and applicable laws. Supervisory responsibilities include interviewing, hiring, and training employees; planning, assigning and directing work; appraising performance; rewarding and disciplining employees; addressing complaints and resolving problems.
No. Direct Reports (incl. titles) CDI Supervisor and CDI Lead
No. Indirect Reports (incl. titles) CDI Lead and CDI Specialist

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

• CDI Subject Matter Expert
• Knowledge of Medicare Part A and familiar with Medicare Part B
• Knowledge of disease pathophysiology and drug utilization
• Knowledge of MS-DRG classification and reimbursement structures
• PC/Systems literate including the Internet and MS office skills
• Ability to apply coding conventions, official guidelines, and Coding Clinic advice to health record documentation
• Management of multiple priorities – effective time management skills
• Leadership and organizational skills along with critical, deductive reasoning and problem solving skills
• Effective written and verbal communication skills including report writing and presentation skills
• Capacity to work independently in a virtual office setting or at facility setting if required to travel for assignment.
• Understand and communicate documentation strategies
• Recognize opportunities for documentation improvement
• Formulate clinically, compliant credible queries
• Ability to maintain an auditing and monitoring program as a means to measure query process
• Report writing with management review
• Skilled in performing quality assessment/analysis
• Overall knowledge and ability to drive operational metrics.
• Overall knowledge of the flow of the revenue cycle
• Detail oriented and analytical skills
• Assess, coach, train and develop talent
• Possesses the ability to motivate and maintain effective working relationships with staff and all stakeholders.
• Demonstrates strength in both performance management and leadership development
• Manage change while minimizing interruption at an operational and service leve

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

• Ability to sit for extended periods of time
• Must be able to efficiently use computer keyboard and mouse
• Good Visual acuit