Manager- Inpatient Clinical Documentation Improvement Program

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Business (Non-Clinical)
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1810406 Requisition #
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GENERAL SUMMARY:

The Inpatient Clinical Documentation Improvement (CDI) Manager is responsible for managing, coordinating, and performing day-to-day operations for the inpatient clinical documentation improvement program across the multi-facility integrated healthcare delivery system. Day-to-day operations include personnel management, education, training, productivity, work assignments, quality reviews, and report management for the inpatient CDI program. Acts as a liaison for physicians, medical group leadership, clinical and ancillary departments regarding appropriate clinical documentation, coding rules and regulations, MS-DRG analysis and reimbursement guidelines. Actively supports and monitors revenue cycle processes. Facilitates and promotes standardization across Henry Ford Health System and ensures alignment of high quality documentation and coding that supports compliant and accurate medical record documentation.


 

PRINCIPLE DUTIES AND RESPONSIBILITIES:

  • Responsible for system wide inpatient documentation quality consistent with regulatory, third party payer requirements and revenue cycle.
  • Works collaboratively with physician champions, clinical staff, quality, care management, and coding to improve the quality of clinical record documentation.
  • Facilitates appropriate clinical documentation reviews to support accurate assignment of diagnoses and procedure codes, severity of illness, risk of mortality, MCC/CC capture, appropriate POA assignment, PSI, HAC, and provider queries
  • Lead team that performs quality reviews to ensure compliance with regulatory compliance, regulatory standards, and industry best practices
  • Responsible for maintaining ongoing inpatient documentation compliance for each business unit in the health system.
  • Conducts data and root cause analysis and communicates clinical documentation opportunities and/or concerns to key stakeholders in a timely and effective manner
  • Contributes to CDI strategic planning and process improvement activities
  • Monitors achievement of CDI key performance indicators and initiates and executes action plans as appropriate.
  • Serves as liaison to physicians, quality and case management teams, and Inpatient Coding teams to ensure appropriate documentation and reimbursement.
  • Maintains current knowledge of payer/reimbursement requirements, MS-DRGs, ICD-10 and CPT coding, actively communicates updates to coding and clinical documentation improvement staff.
  • Provides ongoing formal and informal education to the medical staff regarding coding documentation rules and regulations, MS-DRG coding and reimbursement guidelines.
  • Participates in multidiscipline teams related to inpatient documentation revenue cycle and participates in clinical rounds as required/applicable.
  • System wide responsibility for development, reviewing and maintaining inpatient CDI policies and procedures.
  • Maintains a working knowledge of applicable Federal, State and local laws and regulations, the Integrity/Compliance Program, Code of Conduct, as well as other policies and procedures in order to ensure adherence in a manner that reflects honest, ethical and professional coding and documentation compliance.
  • Collaborates with Corporate Director of CDI to evaluate the performance of Henry Ford Health System CDI team along with; interviews, hires, trains, mentors and disciplines associates according to Human Resource policies and procedures.
  • Takes the initiative to make decisions and is an advocate for change and quality improvement in Inpatient CDI operations, procedures and processes to support the current and future needs of the revenue cycle and health system. 
  • Oversees and maintains the integrity and quality of Inpatient CDI program.
  • Responsible for implementation and oversight of ongoing Inpatient CDI program initiatives.
  • Maintains ongoing accountability to analyze and interpret data to provide focused education and documentation improvement processes.
  • Responsible for planning, directing, and evaluating assigned employees as they provide CDI services to Business Units and HFHS departments.
  • Assigns, distributes, reviews work assignments ensuring timely and accurate completion. Monitor deadlines. 
  • Identifies internal staff development needs and opportunities for improvement or enhancement of staff skills. 
  • Responsible for the quality of services provided to Business Units and HFHS departments. 
  • Responsible for leadership and development of assigned CDI staff, including the identification of internal and external development opportunities to enhance the skills offered to HFHS customers. 
  • Interviews job applicants for department vacancies, recommends pay increases, and recommends discipline and termination of assigned personnel as warranted. Prepares mid-year and annual performance appraisals for all assigned staff. 
  • Plans and manages department resources including developing a department budget. Performs resource planning and scheduling of department personnel to ensure customer requirements are met. 
  • Other duties may be assigned.

 

 

EDUCATION/EXPERIENCE REQUIRED:

  • Bachelor’s Degree in Business Administration, Healthcare Administration or Nursing.
  • Five (5) years clinical operations experience as evidenced by Acute Care Nursing and/or Coding and CDI experience.
  • Significant project management experience and outstanding analytical, communication and interpersonal skills.
  • Analytical ability necessary to conduct basic research, analyze and interpret data, evaluate processes and propose improvements.
  • Ability to manage, coordinate, and lead simultaneously.
  • Ability to estimate time frames and meet projected deadlines. 
  • Ability to understand and lead change.
  • Ability to develop strong working and collaborative relationships with physician leaders in clinical and academic settings.
  • Demonstrates clinical competence.
  • Demonstrate experience in all areas of medical record functions, including privacy & compliance regulations.
  • Demonstrates strong knowledge of ICD-10 CM/PCS conventions, rules and regulations.

CERTIFICATIONS/LICENSURES REQUIRED:

  • Registered Nurse (RN or BSN) required.
  • Clinical Documentation Certification through ACDIS or AHIMA preferred.


 

 

 

 

 

 

 

 

     Overview

       Henry Ford Health System, one of the largest and most comprehensive integrated U.S. health

       care systems, is a national leader in clinical care, research and education.  The system includes

       the 1,200-member Henry Ford Medical Group, five hospitals, Health Alliance Plan (a health

       insurance and wellness company), Henry Ford Physician Network, a 150-site ambulatory

       network and many other health-related entities throughout southeast Michigan, providing a

       full continuum of care.  In 2015, Henry Ford provided $299 million in uncompensated care.

       The health system also is a major economic driver in Michigan and employs more than 24,600

       employees.  Henry Ford is a 2011Malcolm Baldrige National Quality Award recipient.  The

       health system is led by President and CEO Wright Lassiter III.  To learn more, visit HenryFord.com.

     Benefits

       Whether it's offering a new medical option, helping you make healthier lifestyle choices or

       making the employee enrollment selection experience easier, it's all about choice.  Henry

       Ford Health System has a new approach for its employee benefits program - My Choice

       Rewards.  My Choice Rewards is a program as diverse as the people it serves.  There are

       dozens of options for all of our employees including compensation, benefits, work/life balance

       and learning - options that enhance your career and add value to your personal life.  As an

       employee you are provided access to Retirement Programs, an Employee Assistance Program

       (Henry Ford Enhanced), Tuition Reimbursement, Paid Time Off, Employee Health and Wellness

       and access to day care services at Bright Horizons Midtown Detroit, and a whole host of other

       benefits and services.  Employee's classified as contingent status are not eligible for benefits.    

      Equal Employment Opportunity/Affirmative Action Employer

        Equal Employment Opportunity / Affirmative Action Employer Henry Ford Health System is

        committed to the hiring, advancement and fair treatment of all individuals without regard to

        race, color, creed, religion, age, sex, national origin, disability, veteran status, size, height,

        weight, marital status, family status, gender identity, sexual orientation, and genetic information,

        or any other protected status in accordance with applicable federal and state laws.

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