[Hiring] Director of Clinical Documentation Integrity @Guidehouse

Role Description

The Director of Clinical Documentation Integrity demonstrates a high level of clinical proficiency and critical thinking skills necessary for oversight and success of the CDI solution. The CDI Director, in collaboration with the hospital clinical leadership, creates a support structure within the medical staff for achieving clinical and operational excellence in relation to Clinical Documentation Integrity efforts. Works collaboratively with Guidehouse and facility CDI leadership team to meet contractual obligations, achieve best practice CDI metrics and assist in meeting overall organizational goals related to documentation improvement. The CDI Director must demonstrate ability to design and manage process and workflow improvements, system implementations and project management. The CDI Director will be instrumental in determining metric measurements that are meaningful to the organization and demonstrate solution success.

Will assist in analyzing, tracking, trending and reporting CDI and/or organizational data and metrics. The CDI Director in coordination with the Guidehouse CDI leadership, will be responsible to ensure the CDI team has the education and tools necessary to be successful and compliant. The CDI Director will collaborate extensively and in a collegial manner with Physician Advisors, Chief Medical Officer (CMO), Chief Quality Officers (CQO’s), other key providers and client site Department leaders. Actively participates on committees and presents at the monthly revenue cycle meetings to demonstrate solution performance and improvement in clinical documentation. The CDI Director will escalate issues/concerns to the Vice President of CDI.

Qualifications

• Requires a University Degree and minimum 12 years of prior relevant experience; (Relevant experience may be substituted for formal education or advanced degree)
• At least one of the following: RN, MD or MD equivalent, RHIA, RHIT or CCS
• Must maintain credential while employed.
• Requires at least 5 years acute care hospital CDI leadership experience.
• Requires at least 3 years prior management experience.
• Familiarity with encoder and DRG assignment (MS and APR)
• Strong clinical understanding of disease processes, clinical indicators and treatment.
• Maintains current working knowledge of Official Coding Guidelines, Coding Clinic and federal updates to DRG system (MS, APR, AP etc.)
• Understands PSI, HAC and mortality observed to expected impact as it relates to coding and CDI.
• Ability to converse with physicians in sometimes difficult scenarios.
• Ability to conduct meaningful presentations to facility physicians and leadership.

Requirements

• Expert knowledge/experience in managing all aspects of a Clinical Documentation Improvement Solution to include CDI productivity, quality, education and training, compliance auditing, data analysis and trending, report management, performance improvement initiatives and developing standardized, efficient practices, processes and workflows as well as standard operating procedures.
• Broad knowledge of health care regulations. The ability to interpret, adapt, and apply guidelines and procedures, in addition to the ability to analyze complex clinical scenarios and apply critical thinking.
• Assist in the development of processes, workflows and technology optimization designed to improve clinical documentation performance and outcomes.
• Demonstrate effective and meaningful communication skills and collaboration with medical staff, clinical departments and other key facility leadership team members.
• Maintains and demonstrates expert knowledge of CDI and coding process best practices.
• Strong knowledge and understanding in the ever-changing arenas of coding guidelines, DRG payer groups, clinical documentation trends, hospital acquired conditions (HAC’s), patient safety indicators (PSI’s), mortality modeling and core measure guidelines.
• Must have extensive knowledge of reimbursement systems, federal, state, and payer-specific regulations and policies pertaining to documentation and coding.
• Strong project management skills.

Benefits

• Medical, Rx, Dental & Vision Insurance
• Personal and Family Sick Time & Company Paid Holidays
• Position may be eligible for a discretionary variable incentive bonus
• Parental Leave
• 401(k) Retirement Plan
• Basic Life & Supplemental Life
• Health Savings Account, Dental/Vision & Dependent Care Flexible Spending Accounts
• Short-Term & Long-Term Disability
• Tuition Reimbursement, Personal Development & Learning Opportunities
• Skills Development & Certifications
• Employee Referral Program
• Corporate Sponsored Events & Community Outreach
• Emergency Back-Up Childcare Program