CDI Manager

MedStar Health
United States, Maryland, Columbia
5565 Sterrett Place (Show on map)
Nov 13, 2024
General Summary of Position Oversees the daily activities of the Clinical Documentation Integrity (CDI) program at MedStar Health. Monitors CDS metrics including productivity, code assignment, and query content and quality. Fosters provider engagement, relationships, and collaboration with the CDI team. Supports CDI relations and development. Demonstrates a collaborative approach with Health Information Management, Finance, Compliance, Physician advisors, Medical Directors and other hospital departments, to improve the overall quality and completeness of clinical documentation. Identifies CDS education, training, performance monitoring, and CDI technology implementation. Manages the Pre/Post bill process. Manages reconciliation and query processes. Collaborates with CDI Director to review prebill findings. lead meetings with teams, discuss process management, workflows, and troubleshoot challenging cases. Monitors analytics to identify program deficiencies. Reviews monthly reporting to identify potential trouble areas. Collaborates with extradepartmental departments to improve organizational metrics. Review analytics to identify areas for improvement and challenges associated with CMI. Participates in monthly steering committees. Is guided by the Association of Clinical Documentation Improvement Specialists (ACDIS) "Code of Ethics" and the American Health Information Management Association's (AHIMA) "Ethical Standards for Clinical Documentation Improvement Professionals" and the Official Guidelines for Coding and Reporting. These functions are performed in accordance with all applicable laws and regulations and MedStar Health philosophy, policies, procedures and standards. Primary Duties and Responsibilities Ensures the CDS duties are performed accurately and efficiently following all applicable rules and regulations. Manages CDI workflow to consistently meet the CDS performance standards including, but not limited to, productivity (initial reviews and follow up reviews), query rate, and documentation clarification rate. Develops and maintains reporting tools specific to productivity and outcomes. Evaluates the daily functions of the CDI staff to identify and resolve process issues and maintain productivity. Analyzes, assesses, and interprets clinical data to identify gaps, inconsistencies, and/or opportunities for improvement in the clinical documentation. Develops CDS audit plan and schedule. Performs audits on all CDS reviews and provides performance feedback and summaries to CDI staff and leadership to achieve outcomes. Conducts second level reviews and identifies missed query opportunities on conditions necessitating additional clarification within the medical record. This includes quality indicators and risk adjustment conditions. Facilitates modifications to the record to ensure that documentation accurately reflects each patient's severity of illness and risk of mortality. Maintains work queues for bundled DRG's, mortality records and all charts deemed to require a second level review. Facilitates improvement in the overall quality, completeness, and accuracy of medical record documentation through extensive interaction with clinicians. Collaborates with the CDI Physician Advisor, coding staff, clinical quality staff, analytics staff and leadership to assess CDI opportunities and implement solutions to ensure program success. Utilizes data, technology, and creates reports, process flows and action plans to improve performance. Ensures departmental tracking logs are kept current and presents productivity and impact metrics to leadership. Applies benchmarks, monitors performance, implements improvements, and tracks progress. Represents the CDI department at internal and external meetings as required. Works with EMR support team to ensure proper documentation templates are created and maintained. Manages the Human Resources activities for direct reports and department staff in regard to recruiting and selection, hiring and termination, training, professional development, mentoring, counseling and performance evaluations. Coordinates CDS schedules to ensure appropriate coverage. Assumes leadership regarding technology application related to CDI. Develops and conducts ongoing education for new staff, including new CDS, physicians, residents, nurses, and other allied health professionals. Collaborates with internal and external key customers including Finance, HIM, Compliance, Physician liaisons, Medical Directors, Payers, Providers, and Care Management department staff to achieve improved outcomes. Formulates, recommends, implements, monitors and controls operational budgets within administrative guidelines. Appraises forecasts and determines desired set of future conditions and strategies required to achieve the goals and objectives of the organization within incumbent's area of expertise. Assumes other duties and responsibilities that are appropriate to the position and area.A The above responsibilities are a general description of the level and nature of the work assigned to this classification and is not to be considered as all-inclusive. Minimum Qualifications Education Bachelor's degree in a health care related field. required and Master's degree in a health care related field. preferred Consideration will be provided for clinicians (i.e. graduates of medical schools outside the U.S. but not yet licensed to practice in the U.S.). Experience 5-7 years 5 years CDI experience required and 3-4 years 3 years management experience in an acute care setting required Licenses and Certifications RN - Registered Nurse - State Licensure and/or Compact State Licensure Upon Hire required and Certified Coder (CPCODER)-AHIMA or AAPC AHIMA or ACDIS certification (CDIP or CCDS) preferred and Knowledge, Skills, and Abilities Excellent knowledge of clinical documentation integrity and coding. Must have excellent communication (written and verbal) skills. Strong organizational, problem-solving and critical thinking skills. Ability to work independently using excellent judgment to handle sensitive matters in an appropriate manner. Excellent coaching and counseling skills. Ability to balance clinical and management responsibilities. Must be able to manipulate and analyze statistical data. Must be able to work with all levels of personnel within the Hospital. Preferred: Quality improvement process skills. Proficient in the use of computers to perform daily work including Microsoft Office (Word, Excel, PowerPoint, etc.), Ability to collect and analyze data related to the CDI program Excellent interpersonal and team building skills, with an ability to collaborate effectively with physicians, nurses and members of the health care team. This position has a hiring range of $93,142 - $175,968