Manager - Clinical Documentation Integrity
4 weeks ago
Overview
Job Summary
The Advocate Health Condition Management and Documentation team is excited to announce an opening for a new leader for clinician activation programs. This leaders will be a key subject matter expert for clinical documentation and risk adjustment coding within the enterprise. This position focuses on priorities for Enterprise Population Health within the Southeast region.
The Manager of Clinical Documentation Integrity is responsible for the clinical and administrative leadership of documentation excellence initiatives. Responsible for staff management and development, quality, service excellence, workplace experience and financial outcomes. This clinical position uses clinical/nursing knowledge and understanding of national coding guidelines and standards of compliance to improve overall quality and completeness of clinical documentation within the patient electronic medical record using a multidisciplinary team process. Exhibits expertise associated with advanced certification in CDI. Partners with Medical and other leaders to achieve goals to improve quality of care metrics. Assumes accountability as delegated by the Director.
Essential Functions:
- Position manages and develops interprofessional teams, providing leadership and strategic direction for multiple value-based initiatives, including clinical documentation integrity, pre-visit planning, project management, educational programs, and data collection and analysis.
- Helps develop critical workflows and is responsible for reporting and monitoring key performance measurement activities.
- Upholds all AAH leadership behaviors while performing program oversight.
- Oversees Clinical Documentation Integrity (CDI) program; monitors and maintains the timeliness of workflow, productivity, and quality of the site CDI program; develops and monitors implementation of site departmental goals/objectives and supports the performance improvement process in conjunction with the Clinical Documentation Director.
- Aligns department with system strategy, vision, mission, and goals.
- Ensures competency of Clinical Documentation Specialist staff by conducting on-going reviews and skills assessments; provides action plans and timely constructive feedback, as needed, to enhance staff development; leads hiring, training, and performance management processes for all site-based CDI employees; coaches, mentors and empowers employees to complete tasks by providing information and support.
- Performs audits to ensure that the assigned MS-DRG that most accurately reflects the severity of illness of the patient based upon the clinical evidence documented in the record. Reviews clarifications for compliance and assignment of proper impacts. Tracks and trends program compliance to ensure adherence to all CMS regulations regarding DRG assignment.
- Supports the CDI program by generating and analyzing reports and data to identify opportunities for continuous growth and improvement; provides feedback to individual staff and other facility-based leadership. Develops and implements action plans when appropriate.
- Monitors CDI computer applications and assists IAS with quarterly updates and testing as appropriate.
- Demonstrates knowledge and understanding of severity based DRG systems; All-Patient Refined and Medicare Severity (APR-DRG), Medical Severity Diagnostic Related Group System (MS-DRG) and Hierarchical Condition Categories (HCC).
- Interacts with the physician advisor, attending physicians, and/or other designated members of the healthcare team when applicable and follow-up is warranted per escalation guideline.
- Works with other departments such as coding, corporate compliance, quality, and finance to support Corporate Goals.
- Participates in the ongoing education of providers and other healthcare team members to identify medical record documentation improvement opportunities employing conflict resolution skills, as necessary.
- Ensures that all written requests to physicians for additional documentation support Corporate Compliance policies.
- Serves as a clinical leader and systems expert resource.
Physical Requirements
Works in a remote office type setting, extensive walking throughout the facility. Prolonged periods of sitting reviewing medical records and documentation. Repetitive wrist motion and occasional lifting of 10-20 pounds. Intact sight and hearing with or without assistive devices are required. Ability to speak English fluently and write in understandable terms.
Education, Experience and Certifications
Bachelor of Science in Nursing Required. Master’s Degree in Nursing or Health-related field required. Current RN license or temporary license as a Registered Nurse Petitioner in the state in which you work and reside or if declaring a National License Compact (NLC) state as your primary state of residency, meet the licensure requirements in your home state; or for Non-National License Compact states, current RN license or temporary license as a Registered Nurse Petitioner required in the state where the RN works. Additional education, training, certifications, or experience may be required within the department. Minimum of five years direct clinical nursing experience required. Minimum of two years of experience in leadership and clinical documentation improvement preferred.
-
Design Integration Manager
2 weeks ago
Charlotte, United States Samet Corporation Full timeJob DescriptionJob DescriptionSamet seeks a Design Integration Manager who will play a crucial role in bridging the gap between design concepts, design completion and construction phase execution! This Manager may sit in either the Charlotte, Raleigh or Greensboro, NC Region.As the Design Integration Manager, you will play a crucial role in bridging the gap...
-
Physician - Adult Integrated Continuum Clinic
4 weeks ago
Charlotte, United States Atrium Health Full timeOverview If it’s possible, you will find it at Atrium Health—the leading community-focused academic healthcare system serving North Carolina and South Carolina. We invite Behavioral Health Psychiatrists to discover all that we can do when we bring healing hearts, inquisitive minds and progressive visionaries together in our Behavioral Health team in...
-
Adult Integrated Continuum Clinic Physician
2 weeks ago
Charlotte, North Carolina, United States Atrium Health Full timeOverview If it's possible, you will find it at Atrium Health—the leading community-focused academic healthcare system serving North Carolina and South Carolina. We invite Behavioral Health Psychiatrists to discover all that we can do when we bring healing hearts, inquisitive minds and progressive visionaries together in our Behavioral Health team in...
-
Integration Developer
2 days ago
Charlotte, United States Enpro Inc. Full timeSystem Integration Product OwnerAs a System Integration Product Owner, you will work with our Enterprise Integration Product Leader to co-develop the strategy and execution of integrating complex systems using the MuleSoft platform. You will collaborate with cross-functional teams to drive the agile development of integration solutions that maximize business...
-
Integration Developer
1 day ago
Charlotte, United States Enpro Inc. Full timeSystem Integration Product OwnerAs a System Integration Product Owner, you will work with our Enterprise Integration Product Leader to co-develop the strategy and execution of integrating complex systems using the MuleSoft platform. You will collaborate with cross-functional teams to drive the agile development of integration solutions that maximize business...
-
NC Clinical Manager
6 days ago
Charlotte, United States Community Alternatives (VA) Full timeThe Clinical Manager is responsible for the management and quality assurance of all care management provided throughout all North Carolina program sites as well as the administrative oversight of payer authorizations and utilization management for these services from intake through discharge. This includes ensuring all clinical services authorized and billed...
-
Document Management Specialist
7 days ago
Charlotte, United States Equitable Holdings Full timeAt Equitable, our power is in our people. We're individuals from different cultures and backgrounds. Those differences make us stronger as a team and a force for good in our communities. Here, you'll work with dynamic individuals, build your skills, and unleash new ways of working and thinking. Are you ready to join an organization that will help unlock your...
-
NC Clinical Manager
1 week ago
Charlotte, United States Community Alternatives Inc Full timeThe Clinical Manager is responsible for the management and quality assurance of all care management provided throughout all North Carolina program sites as well as the administrative oversight of payer authorizations and utilization management for these services from intake through discharge. This includes ensuring all clinical services authorized and billed...
-
NC Clinical Manager
7 days ago
Charlotte, United States Community Alternatives (VA) Full timeThe Clinical Manager is responsible for the management and quality assurance of all care management provided throughout all North Carolina program sites as well as the administrative oversight of payer authorizations and utilization management for these services from intake through discharge. This includes ensuring all clinical services authorized and billed...
-
NC Clinical Manager
7 days ago
Charlotte, United States Community Alternatives Inc Full timeThe Clinical Manager is responsible for the management and quality assurance of all care management provided throughout all North Carolina program sites as well as the administrative oversight of payer authorizations and utilization management for these services from intake through discharge. This includes ensuring all clinical services authorized and billed...
-
Clinical Data Manager
4 weeks ago
Charlotte, United States Katalyst HealthCares & Life Sciences Full timeResponsibilities: Act as primary liaison between Company and CRO for Data Management. Provide support and oversight for the CRO Data Management team. Collaborate with the team on study design, protocol development, CRF design, statistical planning, and CSRs. Review clinical study protocols and provide comments if any. Provide...
-
NC Clinical Manager
6 days ago
Charlotte, United States Community Alternatives Inc Full timeJob DescriptionThe Clinical Manager is responsible for the management and quality assurance of all care management provided throughout all North Carolina program sites as well as the administrative oversight of payer authorizations and utilization management for these services from intake through discharge. This includes ensuring all clinical services...
-
Accounting Manager
2 weeks ago
Charlotte, United States K2 Integrity Full timeJob DescriptionJob DescriptionK2 Integrity is seeking an Accounting Manager who will report to the Global Controller. The Accounting Manager will be responsible for various activities in corporate accounting for the firm’s US offices. The ideal candidate will be a highly motivated self-starter with a solid understanding of accounting principles and...
-
NC Clinical Manager
6 days ago
Charlotte, NC, United States Community Alternatives Inc Full timeThe Clinical Manager is responsible for the management and quality assurance of all care management provided throughout all North Carolina program sites as well as the administrative oversight of payer authorizations and utilization management for these services from intake through discharge. This includes ensuring all clinical services authorized and billed...
-
NC Clinical Manager
6 days ago
Charlotte, NC, United States Community Alternatives Inc Full timeThe Clinical Manager is responsible for the management and quality assurance of all care management provided throughout all North Carolina program sites as well as the administrative oversight of payer authorizations and utilization management for these services from intake through discharge. This includes ensuring all clinical services authorized and billed...
-
Senior Manager
1 week ago
Charlotte, United States Highline Warren Full timeSenior Manager / Director Integrated Marketing Manager SUMMARY It is an exciting time to join Highline Warren! We are the leading national manufacturer and distributor of consumable and maintenance products for the automotive aftermarket. The company was formed through the strategic combination of Highline Aftermarket and Warren Distribution in 2020. With 20...
-
Senior Manager
2 days ago
Charlotte, United States Highline Warren Full timeSenior Manager / Director Integrated Marketing Manager SUMMARY It is an exciting time to join Highline Warren! We are the leading national manufacturer and distributor of consumable and maintenance products for the automotive aftermarket. The company was formed through the strategic combination of Highline Aftermarket and Warren Distribution in 2020. With 20...
-
RN Clinical Case Manager On-call Specialist
2 weeks ago
Charlotte, United States MGA Homecare Full timeCompany DescriptionMGA Homecare has been providing Private Duty Nursing, Skilled Nursing Visits, Occupational Therapy, Physical Therapy, and Speech Therapy services within the home and community-based setting for over a decade. In 2022 MGA has opened its doors to MGA Behavior Therapy which offers Applied Behavior Analysis (ABA) and early behavior...
-
RN Clinical Case Manager On-call Specialist
1 week ago
Charlotte, United States MGA Homecare Full timeCompany DescriptionMGA Homecare has been providing Private Duty Nursing, Skilled Nursing Visits, Occupational Therapy, Physical Therapy, and Speech Therapy services within the home and community-based setting for over a decade. In 2022 MGA has opened its doors to MGA Behavior Therapy which offers Applied Behavior Analysis (ABA) and early behavior...
-
Documentation Administrator
2 weeks ago
Charlotte, United States Commercial Credit Group Full timeDocumentation Administrator Charlotte, NC Commercial Credit Group Inc (CCG) is an independent national commercial equipment finance and leasing company focused on purchase money and refinance transactions in the construction, fleet transportation, waste/environmental and machine tool industries. CCG does equipment financing different than any other lender....
