Clinical Documentation Integrity Quality & Education Manager

Position Title

Clinical Documentation Integrity Quality & Education Manager

Days - Full Time

Southlake Campus

Position Summary / Career Interest

Oversees the quality and education activities of the Clinical Documentation Integrity (CDI) program at The University of Kansas Health System. Monitors CDIS quality metrics including DRG accuracy, risk adjustment documentation gaps, query content and compliance, and coding collaboration. Fosters provider engagement, relationships, and collaboration with the CDI leadership team. Develops and conducts ongoing education for new staff, including new CDIS, physicians, residents, nurses, and other allied health professionals. Supports CDI relations and development. Demonstrates a collaborative approach with Health Information Management, Finance, Compliance, Coding, Physician advisors, Medical Directors and other hospital departments, to improve the overall quality and completeness of clinical documentation.

Identifies CDIS education, training, quality monitoring, and understanding of CDI technology implementation. Manages the quality and education processes of the CDI department for inpatient and ambulatory documentation. Collaborates with CDI leadership regarding reconciliation and query processes. Collaborates with extradepartmental departments to improve organizational metrics. Review analytics to identify areas for improvement and challenges associated with CMI, population health, and other data measures. Participates in steering committees. Is guided by the Association of Clinical Documentation Integrity 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 healthy system philosophy, policies, procedures and standards.

Responsibilities and Essential Job Functions

• Ensures the CDIS duties are performed accurately and efficiently following all applicable rules and regulations.
• Audits and evaluates 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 quality, education, and outcomes.
• Oversee and evaluate the daily functions of the onboarding of new CDI staff to identify and resolve process issues to assist with achieving productivity expectations.
• Analyzes, assesses, and interprets clinical data to identify gaps, inconsistencies, and/or opportunities for improvement in the clinical documentation.
• Develops CDIS audit plan and schedule. Performs audits on all CDIS 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 for both inpatient and ambulatory CDI programs.
• Identifies and facilitates education to ensure that documentation accurately reflects each patient’s severity of illness and risk of mortality and/or risk adjustment factors.
• Facilitates improvement in the overall quality, completeness, and accuracy of medical record documentation through extensive audits and data review through education and interaction with clinicians.
• Collaborates with the CDI Physician Advisors, Physician Champions, Department Chairs, CMO/CMIO, coding staff, clinical quality staff, analytics staff and leadership to assess CDI opportunities and implement solutions to ensure program success.
• Ensures departmental tracking logs are kept current and presents quality and education impact metrics to CDI leadership.
• Applies benchmarks, monitors performance, implements improvements, and tracks progress.
• Represents the CDI department at internal and external meetings as required.
• Manages the Human Resources activities for direct reports and department staff regarding recruiting and selection, hiring and termination, training, professional development, mentoring, counseling and performance evaluations.
• Coordinates CDIS schedules to ensure appropriate coverage.
• Develops and conducts ongoing education for new staff, including new CDS, physicians, residents, nurses, and other allied health professionals. Collaborates with external and internal key customers including Coding, 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.
• Must be able to perform the professional, clinical and or technical competencies of the assigned unit or department.
• These statements are intended to describe the essential functions of the job and are not intended to be an exhaustive list of all responsibilities. Skills and duties may vary dependent upon your department or unit. Other duties may be assigned as required.

Required Education and Experience

• Bachelors Degree in Health Information Managment, Nursing or a related field of study from an accredited college or university OR
• 7 or more years of experience in Clinical Documentation Integrity program if from a non clinical field
• 5 or more years years of experience in acute nursing if from the clinical field
• 2 or more years supervisory or leadership experience in CDI, revenue cycle or a related field

Preferred Education and Experience

• Master's Degree in Health Information Management, Business Administration, Nursing or a related field of study from an accredited college or university
• 8 or more years experience in multi-specialty physician coding
• 6 or more years of experience in Epic EHR, encoder and other CDI tools
• 2 or more years of quality and education CDI program leadership experience and/or quality or education CDI certification

Required Licensure and Certification

• Registered Nurse license in the State of Kansas or a Compact state license for RN's. OR
• Foreign medical graduate (MD) with CDI certification of CCDS or CDIP may be accepted in lieu of RN license OR
• Registered Health Information Technician (RHIT)-American Health Information Management Association (AHIMA) and Certified Clinical Documentation Specialist (CCDS) or Certified Documentation Integrity Practitioner (CDIP). OR
• Registered Health Information Administrator (RHIA)-American Health Information Management Association (AHIMA) and Certified Clinical Documentation Specialist (CCDS) or Certified Documentation Integrity Practitioner (CDIP) OR
• Certified Coding Specialist (CCS) and Certified Clinical Documentation Specialist (CCDS) or Certified Documentation Integrity Practitioner (CDIP)

Time Type

Full time

Job Requisition ID

R-59264

Important information for you to know as you apply

• The health system is an equal employment opportunity employer. Qualified applicants are considered for employment without regard to race, color, religion, sex (including pregnancy, gender identity, and sexual orientation), national origin, ancestry, age, disability, veteran status, genetic information, or any other legally-protected status. See also Diversity, Equity & Inclusion .
• The health system provides reasonable accommodations to qualified individuals with disabilities. If you need to request reasonable accommodations for your disability as you navigate the recruitment process, please let our recruiters know by requesting an Accommodation Request form using this link asktalentacquisition@kumc.edu .
• Employment with the health system is contingent upon, among other things, agreeing to the health-system-dispute-resolution-program.pdf and signing the agreement to the DRP.

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