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System Manager of CDI

3 months ago

Bozeman, United States Bozeman Health Full time

Approved Remote States:

1. Arizona

2. Florida

3. Georgia

4. Idaho

5. Iowa

6. South Dakota

7. Texas

8. South Carolina

9 . Wisconsin

*Updated Remote States to Align with Business Needs

Position Summary:

The System Manager of Clinical Documentation Improvement (CDI) is responsible for assisting with planning, directing, organizing, monitoring, and staffing departmental services subject to policies, budgets, objectives and directives mandated by regulatory agencies, DNV, and the executive team. Supports revenue and quality data for the health system, through direction and coordination of all CDI functions and maintaining team discipline for all elements of established standard processes (work management, tools, team briefings, metrics tracking, and prompt resolution of issues, problems, and opportunities). Researches, develops, and facilitates education for CDIS and coding teams, as well as clinical partners, in alignment with clinical and coding guidelines. Works closely and collaboratively with all revenue cycle functions, interfacing with PFS, IT, compliance, finance, and physician leaders. This role is critical to the accurate development of claims and reportable quality metrics, using a current working knowledge of organizational structure, coding principles, governmental regulations, protocols, and third party requirements regarding coding and clinical documentation practices to ensure ethical, accurate, and complete coding, preventing and mitigating denials.

Minimum Qualifications:

+ Certified Clinical Documentation Specialist (CCDS), or current Coding Certification (CCA, CPC, CCS/CCS-P) with the equivalent of five (5) years of experience in CDI

+ Three (3) years prior experience in healthcare administration, revenue cycle, health information management, clinical documentation improvement, or coding

+ Three (3) years supervisory or management experience

+ Knowledge of diagnostic and procedural coding systems, electronic code processing

+ Preferred: Associates or Bachelor's degree in Health Information Management and corresponding certification (RHIT or RHIA), or Bachelors degree in Nursing (RN)

+ Preferred: Prior CDI management experience; Epic & 3M proficient

Essential Job Functions:

In addition to the essential functions of the job listed below, employees must have on-time completion of all required education as assigned per DNV requirements, Bozeman Health policy, and other registry requirements.

+ Provides leadership to CDI operations to ensure the provision of comprehensive CDI services in compliance with all regulatory agencies and organizational requirements, through continuous assessment, measurement, and improvement of departmental performance

+ Ensure efficient and precise coding to support the accurate development and submission of claims for reimbursement, including timely filing requirements

+ Monitor, report, and respond to key performance indicators (KPIs), i.e. accounts receivable days, candidate for billing, denials, CC/MCC capture rates, query and response rates, etc.

+ Develop reports/dashboards to summarize CDI trends to the applicable committees, work groups, and department leaders

+ Maintains knowledge of the CPT, ICD-10-CM, and HCPCS coding systems, as well as in depth-knowledge of healthcare reimbursement processes/systems to inform functional needs of the CDI team and revenue cycle partners

+ Collaborates with the system director to ensure a departmental approach to long-range strategic operational planning, care and service design, and development of organizational policies, which reflect the mission of the organization and best practices, and ensure the provision of comprehensive departmental services in compliance with all regulatory agencies and healthcare system requirements

+ Develops and monitors competency content/format and educational resources to ensure team alignment with current coding systems and guidelines

+ Publishes educational material based on latest updates in workflows, regulations, industry guidelines, or clinician requested topics

+ Demonstrates responsible management of all CDI resources, including assessment of staffing models for efficient allocation of resources

+ Demonstrates clinical/technical and managerial competency; ensures staff professional needs are met

+ Assesses current staffing model to determine if CDI functions are resourced appropriately

+ Leads, teaches, inspires, helps and consistently demonstrates hospital healthcare system standards

Knowledge, Skills and Abilities

+ Strong leadership managerial skills; ability to plan, delegate, monitor and improve work performance

+ Demonstrates sound judgement, patience, and maintains a professional demeanor at all times

+ Ability to escalate issues to director and provide possible issue resolution

+ Ability to work in a fast-paced environment

+ Strong interpersonal, verbal, and written communication skills

+ Creativity, problem analysis, and decision making

+ Exercises tact, discretion, sensitivity, and maintains confidentiality

+ Detail oriented, organizational skills, and the ability to prioritize

+ Standard office equipment and computer applications; MS Office, EMR, internet applications etc.

+ Ability to work varied shifts

Physical Requirements

+ Lifting, Pushing, and Pulling: Lift 50 pounds of weight (pick up materials, move equipment, etc.) Carry equipment/supplies. Use upper body strength (repair and maintenance work, etc.)

+ Extended Hours: The role may involve working for extended periods, requiring sitting, walking, or standing for eight or more hours daily.

+ Flexible Schedule: The position may necessitate working beyond a standard 40-hour workweek, including weekends and after-hours shifts.

+ On-Call Availability: On-call work may be required to respond to organizational and patient needs promptly.

+ Effective Communication: Proficient in effective communication, both in person and through various technologies.

+ Handling Challenging Situations: The role may involve dealing with upset individuals, requiring the ability to de-escalate situations and work effectively with frustrated patients or families.

+ Repetitive Tasks: Ability to perform repetitive tasks as needed to fulfill job responsibilities.

Exposures

Tasks Include Potential Exposure: Job tasks may involve exposure to:

+ bloodborne pathogens, such as blood, bodily fluids, or tissues.

+ radiation in settings where medical imaging procedures are performed.

+ various chemicals and medications used in healthcare settings. Job tasks may involve handling cleaning products, solvents, paint, disinfectants, and other substances.

+ infectious diseases due to contact with patients in areas that may have contagious illnesses.

The above statements are intended to describe the general nature and level of work being performed by people assigned to the job classification. They are not to be construed as a contract of any type nor an exhaustive list of all job duties performed by the personnel so classified.

77211350 Compliance

Working at Bozeman Health is more than just a job--it's a commitment to caring for the communities of Southwest Montana by being their partner in health and wellness, compassionately delivering the best care for each person, every time. In every role, our employees are inspired by their ability to care for our community and our Culture of Excellence guides each employee to be a high performer, engage in transparent and timely communication, demonstrate dynamic learning and teaching, excel through change, express gratitude and experience joy.