Director Clinical Documentation Integrity

1 month ago

Dallas, United States Children's Health Full time

Job Title & Specialty Area: Director Clinical Documentation Integrity

Department: Coding and CDI

Location: Trinity

Job Type: Remote

Why Children's Health?

At Children's Health, our mission is to Make Life Better for Children, and we recognize that their health plays a crucial role in achieving this goal.

Through our cutting-edge treatments and affiliation with UT Southwestern, we strive to deliver an extraordinary patient and family experience, ensuring that every moment, big or small, contributes to their overall well-being.

Our dedication to promoting children's health extends beyond our organization and encompasses the broader community. Together, we can make a significant difference in the lives of children and contribute to a brighter and healthier future for all.

Summary:

Supports the strategic vision and provides organizational leadership for Clinical Documentation Integrity (CDI). Serves as a subject matter expert for clinical documentation integrity (CDI), Case Mix Index (CMI) and multiple reimbursement systems (i.e., APR-DRG, Medicare, Medicaid, etc.) to support the appropriate APR-DRG assignment, severity of illness, expected risk of mortality, and complexity of care provided to patients. Facilitates improvement in the overall quality, completeness, and accuracy of medical record documentation through interaction with clinicians. Acts as a coordinator of physician clinical documentation, coding, and reimbursement processes in working towards agreed upon quality and productivity targets for all services in the system. Provides education and training about regulatory and reimbursement changes on an ongoing basis. Oversees and maintains the integrity of the Clinical Documentation Program performance tracking and reporting process. Analyzes data and provides management reports to evaluate the financial impact of the program. Measure the effectiveness of documentation tools, trend and quantify the effectiveness of coding, evaluate the success of concurrent documentation improvement on an ongoing basis.

Responsibilities:

* Responsible for CDI program to initiate, influence, direct and oversee the clinical documentation improvement program activities to include productivity, quality, education and training, auditing, report management, performance improvement initiatives, and developing standardized practices, processes, policies and procedures.
* Facilitates improvement in the overall quality, completeness, and accuracy of medical record documentation through interaction with clinicians.
* Acts as a coordinator of physician clinical documentation, coding, and reimbursement processes in working towards agreed upon quality and productivity targets for all services in the system.
* Collaboratively works with coding, quality, utilization management, physician champions, and other key stakeholders to improve clinical documentation.
* Oversees and maintains the integrity of the Clinical Documentation Program performance tracking and reporting process.
* Analyzes data and provides management reports to evaluate the financial impact of the program.
* Conducts data and root cause analysis and communicates clinical documentation opportunities and/or concerns to key stakeholders in a timely and effective manner.
* Continually examine program effectiveness against industry changes, threats, and opportunities.
* Develop and review policies and procedures that establish standards for clinical documentation integrity.
* Strategically Coordinate education to providers regarding overall documentation best practices and requirements. This will include elements for complete documentation availability, documentation integrity, compliance, and patient profiling.
* Assist with reviews of all Medicare and Medicaid audits including but not limited to RAC, THHS,
* CMS as needed.

This is a full-time position working Monday through Friday from 8:00 a.m. to 4:30 p.m.

You may be required to float occasionally to other Children's Health locations including Dallas, Plano and clinics.

WORK EXPERIENCE

* At least 7 years' experience with inpatient coding and/or clinical documentation Required
* At least 3 years management experience Required

EDUCATION

* Four-year bachelor's degree or equivalent experience Nursing, Health Information Management, or similar related field of study Required
* Graduate or professional work or advanced degree; or equivalent experience Preferred

LICENSES AND CERTIFICATIONS

* Registered Health Information Administrator (RHIA), Registered Health Information Technician (RHIT), Registered Nurse (RN), Certified Coding Specialist (CCS), Clinical Documentation Improvement Practitioner (CDIP) or Certified Clinical Documentation Specialist (CCDS) Required

A Place Where You Belong

We put our people first. We welcome, value, and respect the beliefs, identities and experiences of our patients and colleagues. We are committed to delivering culturally effective care, creating meaningful partnerships in the communities we serve, and equipping and developing our team members to make Children's Health a place where everyone can contribute.

Holistic Benefits - How We'll Care for You:

* Employee portion of medical plan premiums are covered after 3 years.
* 4%-10% employee savings plan match based on tenure
* Paid Parental Leave (up to 12 weeks)
* Caregiver Leave
* Adoption and surrogacy reimbursement >>

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