Minimum Education:
Graduate of an accredited school of registered nursing and/or foreign medical graduate
Minimum Experience/Knowledge:
⢠Minimum of two yearsâ clinical experience in an acute care setting and at least two years of CDI experience.
⢠Minimum of one year as a lead clinical documentation specialist
⢠Academic Medical Center CDI experience preferred
⢠Advanced clinical expertise and extensive knowledge of complex disease processes with broad based clinical experience in an inpatient setting.
⢠Knowledge of care delivery documentation systems and related medical record documentation.
⢠Strong broad based clinical knowledge and understanding of pathology/physiology of disease processes.
⢠Expertise on:
⢠ICD10 CM & PCS, coding clinic and Official Guidelines for Coding and Reporting
⢠Risk and Severity-Stratification Models: MS-DRG, APR-DRG, HCC, Other
⢠Quality metrics: Patient Safety Indicators (PSIs), Mortality Index, Hospital Acquired Conditions (HACs), Other
⢠AHIMA and ACDIS CDI regulations, standards and code of ethics
⢠Proficiency with Microsoft Applications, including word processing, spreadsheets and presentation software
⢠Extensive knowledge and experience in reporting software and electronic medical record systems
⢠Demonstrated leadership ability
⢠Maintains working knowledge of Medicare/Medicaid rules and regulations regarding CDI, POA (present on admission), basic coding, as well as current trends and developments in the area of Clinical Documentation Improvement (CDI)
⢠Ability to work with senior management, physicians, and medical center staff with various levels of education and experience
⢠Ability to develop and maintain strong, collaborative and supportive working relationships with CDI peers, physicians and other clinical professionals
⢠Must have demonstrated interpersonal, verbal and written communication skills in dealing with multidisciplinary teams and variety of ongoing activities
⢠Knowledge of computer systems and software used in functional area
⢠Knowledge of project management processes and systems
⢠Knowledge of statistical analysis and reporting practices pertaining to quality improvement and program evaluation
⢠Demonstrated organizational, project management skills
⢠Ability to be creative and innovative in a high volume work environment
⢠Ability to communicate effectively, both orally and in writing
⢠Ability to lead teams and produce project results within schedule and budget
⢠Ability to plan, organize, motivate, mentor, direct and evaluate the work of others
⢠Ability to provide leadership and influence others
⢠Ability to work effectively with individuals at all levels of the organization
⢠Ability to work independently
⢠Skilled and experienced in data analysis and qualitative reporting of results
⢠Skill in developing and delivering training and education to clinical, CDI and coding professionals regarding CDI practices, coding and documentation requirements
⢠Demonstrated organizational and critical thinking skills, ability to assess, evaluate and teach
⢠Skilled in adaptability and self-motivation in staying abreast of CDI practices, coding changes and clinical practices
⢠Demonstrated judgment and independent decision making
⢠Ability to motivate, train and teach individuals; demonstrated skills in interpersonal relationships and in oral and written communication. Ability to analyze and prioritize work efforts and organize and coordinate multiple functions and tasks.
Required License/Certification:
Valid Registered Nurse license or foreign medical graduate.
Clinical Documentation Improvement Certification(s): Certified Clinical Documentation Specialist (CCDS) - ACDIS and/or Certified Clinical Documentation Improvement Practitioner (CDIP) - AHIMA
Coding Certification: Certified Coding Specialist (CCS) - AHIMA
Fire and Safety Certification. If no card upon hire, one must be obtained within 30 days of hire, and maintained by renewal before expiration date.
The Clinical Documentation Improvement (CDI) Program Manager uses clinical, ICD coding, government and non-government regulations and CDI expertise to perform daily operational management of the CDI program and CDI Staff. This position evaluates the adequacy and effectiveness of internal and operational controls designed to ensure that CDI processes and practices lead to appropriate execution of regulatory requirements and guidelines related to facility coding and CDI practices, including federal and state compliance standards.This position plays a key role in leading the initiative for obtaining complete, accurate and compliant documentation for appropriate reimbursement of services provided and capture of clinical outcome measures. Recruits, hires and develops clinical documentation specialists to establish, maintain and keep current an effective training program for clinical documentation. Assist with denial/appeal process in response to documentation denials on audited claims. Assists with the management of monthly and ad hoc reporting for CDI program performance, including that of CDI staff and providers. Assists in the performance of audits and analyzes the findings of performance audit information to build staff education, identify areas of individual and team performance opportunity and resolve as needed. This position will draft and manage CDI Program Department policies and processes. The CDI Manager will work with the Director of CDI to implement CDI program strategies in collaboration with HIM, Coding leadership. Quality and Compliance Departments to coordinate provider documentation best practices. |
