Manager Clinical Documentation Integrity and Education - CCH
Cape Cod Hospital
March 2, 2018
Full Time - Experienced
TITLE: Manager Clinical Documentation Integrity and Education - CCH JOB CODE: MY21DB GRADE: Y21D DEPARTMENT: CCH - Clinical Resource Management REPORTS TO: CCH - Executive Director SUPERVISES: CDI
PURPOSE OF POSITION: The Manager of Clinical Documentation Integrity is responsible for the day to day operations and clinical management of the CDI program staff, oversees the overall CDI review processes and maintains the integrity of the daily operations. This position is also responsible for developing and conducting ongoing education for CDI and CM/SW staff.
PRIMARY DUTIES AND RESPONSIBILITIES:
Day to day management of the clinical documentation integrity program staff and workflows
Active collaboration with Director, HIM, Quality and Revenue Cycle teams to facilitate highest quality clinical outcomes and revenue capture.
Ongoing development and completion of continuing education programs for Clinical Resources Management staff, including CDI, case managers and social workers specifically related to role functions and implementation of new processes.
Provides ongoing Clinical Documentation management program education for new staff, including new Clinical Documentation Registered Nurses, physicians, nurses and allied health professionals.
Tracks and trends program compliance.
Develop, mentor and coach continual improvement in the collaborative practice between physicians and CDI’s.
Remains current with coding information to ensure accuracy of codes assigned based on documentation.
Assists coders’ when querying physicians regarding unclear documentation
Analysis and review of program metrics
Extensive knowledge of treatment methodology, patient care assessment, data collection techniques and coding classification systems
Knowledge of organizational policies and procedures,
Skill in identifying problems and recommending solutions.
Skill in preparing and maintaining records and written reports
Understand and communicate differences between Medicare Part A and Part B guidelines and how they impact DRG assignments
Understands commercial insurer requirements re: CDI and completes review of medical records appropriate to those requirements
Provides coverage for the Manager of Case Management
Consistently provides service excellence to all patients, family members, visitors, volunteers and co-workers in a manner that reflects Cape Cod Hospital’s commitment to CARES: compassion, accountability, respect, excellence and service.
Extensive knowledge of clinical documentation integrity, professional education concepts and program development interaction with physicians, HIM professionals, and nursing staff.
Bachelor level degree in Nursing required. Masters Degree preferred
Current Massachusetts Registered Nurse license
Certification in clinical documentation integrity preferred
Minimum of two years experience in direct nursing care, preferably including intensive care nursing with expert knowledge of pathophysiology and disease process
Two years experience in process improvement; experience in IDC-9, ICD-10, CDI, coding, utilization review or other relevant area
Experience in development and presentation of professional continuing education programs
Knowledge and orientation to ICD-10
Knowledge of CMS regulations, including Medicare A and B
Excellent computer skills – familiarity with Windows based software programs
Organizational, analytical, writing and interpersonal skills
Management/supervisory experience preferred
***Must successfully complete or have completed a JATA Clinical Competency Exam*** prior to interview process
Cape Cod Healthcare is an award-winning, comprehensive regional healthcare system based in Hyannis, Massachusetts. With more than 400 physicians, 4,000 employees, and 1,000 volunteers, Cape Cod Healthcare operates two-acute care hospitals, the largest home health services agency on the Cape (VNA), skilled nursing and rehabilitation facilities, an assisted living facility and numerous health programs. In 2013, CCHC was named one of America’s top 15 healthcare systems by Truven Health Analytics, a leading provider of information and solutions to improve the cost and quality of healthcare. CCHC was cited for its achievements in providing high-value, community-based care with positive outcomes and fewer complications for patients. Quality, safety, and patient satisfaction are at the heart of everything we do!