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Rochester Regional Health · 3 months ago

Director, Clinical Documentation Improvement - Quality and Safety Institute

Rochester, NY

Full-time

Onsite

Lead/Staff, Director/Executive

$105K/yr - $135K/yr

5+ years exp

Rochester Regional Health is focused on advancing the success of their Clinical Documentation Improvement program at the system level. The Director is responsible for providing education, support, and oversight to the Clinical Documentation Improvement Team across multiple facilities, ensuring accurate and timely clinical documentation while meeting established performance metrics.

Health CareHospitalMedicalPrimary and Urgent CareWellness

Responsibilities

Responsible for CDI operations ensuring timeliness, accuracy, completeness, consistency, compliance and standards fulfillment as defined in RRH and HIM policies, guidelines and performance standards

Provides direct managerial oversight to CDI Team in management of CDI processes CDI projects, barriers and education work processes, to include quality reviews and educational classes

Maintains up-to-date knowledge of regulatory changes impacting coding requirements and ensures CDI staffs are appropriately educated

Responsible for systematic approaches that contribute to a quality health record, while maintaining strong regulatory and legal compliance, and high levels of customer service

Responsible for the development and management of strategy, specific goals, objectives, budgets and performance standards for the RRH CDI program

Responsible for implementing, developing and maintaining a CDI program

Serves as an educator for the CDI Team and other healthcare professionals/departments in the use of coding guidelines and proper documentation requirements as it relates to data quality management and reimbursement

Responsible for the recruitment, selection, orientation and retention process. Provides coaching, counseling, and mentoring as appropriate. Completes performance appraisals for team members according to system schedule

Coordinates and/or facilitates on-going CDI meetings and training

Analyzes Case Mix Index for trends, determine root cause and address as appropriate

Prepares statistical and narrative reports

Represents the HIM Department through participation in various system committees and work groups, including billing, revenue cycle, denials, and others as assigned

Ensure effective staffing levels by evaluating RRH volumes

Ensure effective scheduling of CDI team to ensure proper coverage

Demonstrate proven leadership and management skills to promote effective and efficient review of physician documentation and the medical record

Demonstrate knowledge and job experience in management and supervision of personnel, including team building and conflict resolution

Collaborate with interdisciplinary teams including, but not limited to Physician Advisors (Pad), physicians, nurse practitioners, PA's, mid-level practitioners and the department managers for Revenue Integrity, Coding and Data Quality, Case Management and Health Information Management

Develops the direction and education of all phases of the Clinical Documentation Improvement process

Provide ongoing program education for new staff, including new Clinical Documentation Improvement Registered Nurses, physicians, nurses and allied health professionals

Tracks and trends program compliance to ensure adherence to all CMS regulations regarding DRG assignment

Assume responsibility for professional development through participation at workshops, conferences, and/or in-services and maintains appropriate records of participation

Develops performance targets for each facility and disseminate reports to appropriate administrative personnel indicating productivity and success of the CDI program

Demonstrates extensive knowledge of reimbursement systems (MS-DRG), as well as federal, state and payer-specific regulations and policies pertaining to documentation, coding and billing

Demonstrates advanced clinical expertise and extensive knowledge of complex disease processes in an inpatient setting

Exhibits excellent observation skills, analytical-critical thinking, problem solving, plus effective oral and written communication skills

Performs other duties as assigned

Qualification

Certified Clinical Documentation SpecialistClinical Documentation ImprovementManagement experienceEPICAcute care experienceAnalytical skillsTeam buildingLeadership skillsCommunication skillsProblem solving

Required

Must obtain Certified Clinical Documentation Specialist (CCDS) within two years of hire

Minimum five years acute care experience required

RN (must be licensed in the state of New York), BSN, or other clinician with advanced clinical knowledge, including: MDs or international physicians; physician assistants; or, Nurse Practitioners