System CDI and Coding Director

3 weeks ago


RI United States Care New England Health System Full time

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:

  1. The oversight and guidance of both hospital and professional coding, including the operational functions of the CDI and Coding departments.

Duties and Responsibilities:

  1. Ensures regulatory compliance is met with respect to both hospital and professional coding and clinical documentation improvement.
  2. Develops and leads departmental processes to review new regulatory developments and communicates to affected departments.
  3. Evaluate professional coding across the system to identify opportunities to standardize processes and create new centralized workgroups to improve accuracy and maximize reimbursement.
  4. Demonstrates 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.
  5. Oversees the Clinical Documentation Improvement staff to ensure best practices for the CDI program.
  6. Monitor and communicate patterns, trends, and insurer updates to identify areas of improvement.
  7. Compiles, analyzes, and evaluates quality and clinical data collected as part of an integrated system-wide program of clinical improvement and documentation requirements.
  8. 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.
  9. Meet cost and quality standards by demonstrating creativity in responding to healthcare trends.
  10. Review budgetary reports and submit capital budget requests.
  11. Identify opportunities to automate processes utilizing current and/or new systems to accelerate and improve coding.
  12. Lead and participate in the Electronic Medical Record (EMR) transition to Epic.
  13. Continue to then lead and guide for progress improvement of EMR utilization.
  14. Ensures high levels of performance, achievement of goals, and quality of results across CNE through subordinate managers.

Requirements:

  1. Certified Coding Specialist (CCS) required with Certified Professional Coding (CPC) also preferred.
  2. Certified Clinical Documentation Specialist (CCDS) preferred.
  3. CDI preferred.
  4. Experience Minimum 7 Years.
  5. Education: Bachelor's Degree Required.
  6. Excellent oral and written skills required.
  7. Ability to work between clinical, operational, and financial areas is necessary.
  8. Experience with labor management and also the management of a remote workforce is preferred.
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