Clinical Documentation Integrity Manager

Job Family:

CDI Specialist

Travel Required:

None

Clearance Required:

None

What You Will Do

The Clinical Documentation Integrity Manager is responsible for assisting the CDI Director with new client implementations/engagement, work collaboratively with the facility CDI team to meet contractual obligations, and achieve best practice CDI metrics. The CDI Manager will assist in developing or updating CDI policies and procedures, ensure efficient utilization of CDI technology, assist with client month end reporting, continuous monitoring of key performance indicators (KPI’s) and development of CDI education material for both CDI and physicians. The CDI Manager will be responsible to ensure the CDI team has the tools necessary to be successful in their daily, concurrent record reviews, query initiation and follow-up and query compliance reviews. The CDI Manager will escalate issues as necessary to the appropriate CDI management team members. The CDI Manager will work collaboratively with facility team members and departments as required.

Essential Job Functions

• Expert knowledge/experience in directing all aspects of a Clinical Documentation Improvement Solution

• Ability to assess and identify potential health system opportunities in regard to contractual and best practice CDI metrics

• Assist in the development of processes and initiatives designed to improve clinical documentation performance

• Strong project management skills

• Demonstrate effective communication skills and collaborates with medical staff, clinical departments and key facility leadership team members

• Effectively utilizes reporting technology to analyze and drive continual improvement for the client and employee engagement

• Maintains and demonstrates expert knowledge of CDI and coding process best practices

• Drives optimal use of the CDI technology tool and reporting capabilities.

• Manages and holds CDI team to key performance indicators

Duties and Responsibilities

• Leads by example, promoting teamwork by fostering positive, transparent and focused working environment to achieve maximum results

• Cultivates exceptional relationships among facility leadership team (HIM Director, Coding team, Case Management, Quality and Medical staff) resulting in support and participation in initiatives which advance business objectives

• Assist in daily CDI program oversight to include productivity, quality, education and training, auditing, report management, performance improvement initiatives and developing standardized practices, processes as well as policies and procedures.

• Become an advocate for facilitating the best practice model for CDI, linking the most accurate capture of documented bedside care to the most accurate numeric reporting codes thereby, conversion into correct reporting, facility and physician profiling and acuity capture.

• Assist in monitoring the performance of each CDI program to ensure alignment and support department and organizational goals as well as compliance in coding and query practices with regulatory requirements.

• The Manager will assist in month end client reporting and analyses to track performance and trends and escalate issues as necessary.

• Assist with CDI technology implementation as required.

• Maintain a clear working knowledge of the CDI technology tool regarding data entry, report generation and tracking methods to ensure the most efficient use of the tool.

• Establish a working understanding of each client, their facility, their internal structure, potential needs and clinical staff/physician/HIM relationship regarding current documentation/coding and severity of illness.

• Seek to build knowledge and understanding in the ever-changing arenas of coding guidelines, DRG payer groups, case management/utilization review functions, clinical documentation trends, JCAHO/core measure guidelines and clinical quality of care issues.

• Assist with in-service training of staff, query compliance quality reviews and physicians as needed.

• Approves CDI timesheets, completes performance evaluations, develops team member performance improvement plans if necessary and monitors compliance learning module completion.

• Clearly communicate and/or escalate program updates, risks or needs in a timely manner to the CDI Director and actively work to resolve and mitigate risk.

• Build trustworthy and strong relationships with client staff, physician base and Guidehouse staff.

Client Service/ Business Development:

• Demonstrates a comprehensive understanding of CDI and Revenue Cycle service offerings as well as Guidehouse service offerings.

• Perceived by the client as a lead person for the CDI Solution.

• May assist with the development of proposals.

• Actively participates in the recruiting process.

Communication:

• Provides regular status updates to VP Operations, CDI Director and department Directors. 

• Demonstrates solid facilitation skills. 

• Actively leads meetings with CDI team and other internal and client personnel at various levels as needed.

• Demonstrates the ability to determine the most appropriate format and scope for client deliverables including the ability to create deliverables suitable for senior-level client and internal audiences. 

• Demonstrates effective listening skills.

• Ability to identify and articulate project obstacles/ issues and determine potential solutions while working collaboratively.

• Expresses self in a confident manner in individual and group settings

What You Will Need

• Bachelor's Degree

• At least one of the following: RN, MD or MD equivalent

• Must maintain credential while employed

• 7+ years acute care hospital CDI experience

• 3+ years prior management experience

• Familiarity with encoder and DRG assignment (MS and APR)

• Strong clinical understanding of disease process

• Maintains current working knowledge of Coding Clinic Guidelines and federal updates to DRG system (MS, APR, AP etc.)

• Knowledge of medical terminology, anatomy, physiology, microbiology, and disease processes

• Excellent communication skills, employing tact and effectiveness

• Ability to converse with physicians in sometimes difficult scenarios

• Ability to conduct presentations to facility physicians and leadership

What Would be Nice To Have

• CCDS or CDIP credential preferred

• RHIA, RHIT, or CCS Certification

The annual salary range for this position is $102,000.00-$170,000.00. Compensation decisions depend on a wide range of factors, including but not limited to skill sets, experience and training, security clearances, licensure and certifications, and other business and organizational needs.

What We Offer:

Guidehouse offers a comprehensive, total rewards package that includes competitive compensation and a flexible benefits package that reflects our commitment to creating a diverse and supportive workplace.

Benefits include:

• Medical, Rx, Dental & Vision Insurance

• Personal and Family Sick Time & Company Paid Holidays

• Position may be eligible for a discretionary variable incentive bonus

• Parental Leave

• 401(k) Retirement Plan

• Basic Life & Supplemental Life

• Health Savings Account, Dental/Vision & Dependent Care Flexible Spending Accounts

• Short-Term & Long-Term Disability

• Tuition Reimbursement, Personal Development & Learning Opportunities

• Skills Development & Certifications

• Employee Referral Program

• Corporate Sponsored Events & Community Outreach

• Emergency Back-Up Childcare Program

About Guidehouse

Guidehouse is an Equal Opportunity Employer–Protected Veterans, Individuals with Disabilities or any other basis protected by law, ordinance, or regulation.

Guidehouse will consider for employment qualified applicants with criminal histories in a manner consistent with the requirements of applicable law or ordinance including the Fair Chance Ordinance of Los Angeles and San Francisco.

If you have visited our website for information about employment opportunities, or to apply for a position, and you require an accommodation, please contact Guidehouse Recruiting at 1-571-633-1711 or via email at [email protected]. All information you provide will be kept confidential and will be used only to the extent required to provide needed reasonable accommodation.

All communication regarding recruitment for a Guidehouse position will be sent from Guidehouse email domains including @guidehouse.com or [email protected].  Correspondence received by an applicant from any other domain should be considered unauthorized and will not be honored by Guidehouse.  Note that Guidehouse will never charge a fee or require a money transfer at any stage of the recruitment process and does not collect fees from educational institutions for participation in a recruitment event. Never provide your banking information to a third party purporting to need that information to proceed in the hiring process.

If any person or organization demands money related to a job opportunity with Guidehouse, please report the matter to Guidehouse’s Ethics Hotline. If you want to check the validity of correspondence you have received, please contact [email protected]. Guidehouse is not responsible for losses incurred (monetary or otherwise) from an applicant’s dealings with unauthorized third parties.

Guidehouse does not accept unsolicited resumes through or from search firms or staffing agencies. All unsolicited resumes will be considered the property of Guidehouse and Guidehouse will not be obligated to pay a placement fee.