Director, Clinical Documentation Integrity

1 week ago


Providence, United States Care New England Health System Full time

Why this Opportunity?

Enterprise impact across all operations

Direct partnership with operating unit senior leaders & System Leadership

Team leadership


Job Summary:


The Care New England - Systems Clinical Documentation Integrity (CDI) and Coding Director collaborates with physicians, nurses, case managers, chief financial officers, and others. Will actively participate as a member of the Leadership Team to support and enforce a culture of excellence in care delivery, customer service, technological efficiency and fiscal integrity.


Primary responsibilities include the oversight and guidance of both hospital and professional coding, including the operational functions of the CDI and Coding departments. Expertise required with both hospital and professional coding and a comprehensive knowledge of CDI operations.


Duties and Responsibilities:


Ensures regulatory compliance is met with respect to both hospital and professional coding and clinical documentation improvement. Develops and leads departmental process to review new regulatory developments and communicates to affected departments.


Evaluate professional coding across the system to identify opportunities to standardize process and create new centralized workgroup to improve accuracy and maximize reimbursement.


Demonstrates a comprehensive knowledge of all procedures concerning the sequencing of diagnoses and procedures including, but not limited to, those outlined in ICD-10-CM, CPT, Uniform Hospital Discharge Data Set, Medicare guidelines and other appropriate classification systems.


Oversees the Clinical Documentation Improvement staff to ensure best practices for the CDI program. Monitor and communicate patterns, trends and insurer updates to identify areas of improvement.


Compiles, analyzes, and evaluates quality and clinical data collected as part of an integrated system-wide program of clinical improvement and documentation requirements.


Manage and direct all activities of the Department by providing leadership and by serving as a resource to evaluate and identify strategies for problem solving.


Meet cost and quality standards by demonstrating creativity in responding to healthcare trends. Review budgetary reports and submit capital budget requests.


Identify opportunities to automate processes utilizing current and/or new systems to accelerate and improve coding.


Lead and participate in the Electronic Medical Record (EMR) transition to Epic. Continue to then lead and guide for progress improvement of EMR utilization.


Ensures high levels of performance, achievement of goals and quality of results across CNE through subordinate managers.


Requirements:


Certified Coding Specialist (CCS) required with Certified Professional Coding (CPC) also preferred,

Certified Clinical Documentation Specialist (CCDS) preferred, and CDI preferred


Experience Minimum 7 Years


Education: Bachelor's Degree Required


Excellent oral and written skills required. Ability to work between clinical, operational and financial areas is necessary. Experience with labor management and also the management of a remote workforce is preferred.


Care New England Health System (CNE) and its member institutions; Butler Hospital, Women & Infants Hospital, Kent Hospital, VNA of Care New England, Integra, The Providence Center, and Care New England Medical Group, and our Wellness Center, are trusted organizations fueling the latest advances in medical research, attracting top specialty-trained doctors, and honing renowned services and innovative programs to engage in the important discussions people need to have about their health.


Americans with Disability Act Statement: External and internal applicants, as well as position incumbents who become disabled must be able to perform the essential job-specific functions either unaided or with the assistance of a reasonable accommodation, to be determined by the organization on a case-by-case basis.


EEOC Statement: Care New England is an equal opportunity employer. All applicants will be considered for employment without attention to race, color, religion, sex, sexual orientation, gender identity, national origin, veteran or disability status.


Ethics Statement: Employee conducts himself/herself consistent with the ethical standards of the organization including, but not limited to hospital policy, mission, vision, and values.



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