Director of Clinical Documentation Integrity

Job Family:

Travel Required:

Clearance Required:

What You Will Do:

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.

Essential Job Functions

• 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.

Duties and Responsibilities

• Assist in CDI assessments, staffing analysis and demonstrate ability to quantify opportunities for improvement and return on investment.
• Demonstrates ability to analyze data and create meaningful, professional, client ready PowerPoint and/or Excel presentations.
• Ability to assess and identify potential health system opportunities for best practice CDI metrics and workflows.
• Monitors the performance of CDI program to ensure alignment with department and organizational goals.
• Works collaboratively with CDI leadership to hold CDI team accountable for meeting key performance indicators and overarching revenue cycle goals.
• Drives optimal use of the CDI technology application and reporting capabilities.
• Assist with CDI technology selection and implementation as required.
• Leads by example, promoting compliance and teamwork by fostering positive, transparent, trusting and focused working environment to achieve maximum results.
• Cultivates strong, trustworthy relationships among facility leadership team (HIM Director, Coding leadership, Case Management, Quality and Medical staff) resulting in support and participation in initiatives which advance business objectives
• Become an advocate for facilitating the best practice model for CDI, linking the most accurate capture of documented bedside care to the most accurate code assignment; ensuring the most accurate reporting for the facility, physician profiling and acuity capture.
• Ensure query compliance training and quality review process established for each CDI solution.
• Assist in approving direct report timesheets, perform quarterly check-in’s and annual performance evaluations meeting required deadlines.
• Complete mandatory Guidehouse compliance modules by due date.

Client Service/ Business Development:

• Active participant in facility meetings
• Demonstrates a comprehensive understanding of CDI and Revenue Cycle service offerings as well as Guidehouse service offerings.
• Perceived by the client as a lead for the Guidehouse CDI Solution.
• Actively participates in the CDI leadership recruiting process.

Communication:

• Provides regular status updates to VP of Operations, client and other Guidehouse leaders
• Demonstrates strong facilitation skills. 
• Demonstrates ability to lead client facing meetings.
• Demonstrates the ability to determine the most appropriate format and scope for client deliverables including the ability to create deliverables suitable for senior-level client and internal audiences. 
• Demonstrates effective listening skills.
• Ability to identify and articulate project obstacles/ issues and determine potential solutions while working collaboratively.
• Expresses self in a confident manner in individual and group settings

What You Will Need:

• 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.

What Would Be Nice To Have:

• Graduate-level education Master’s or Doctorate degree

#LI-DNI

What We Offer:

Guidehouse offers a comprehensive, total rewards package that includes competitive compensation and a flexible benefits package that reflects our commitment to creating a diverse and supportive workplace.

Benefits include:

• 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

About Guidehouse

Guidehouse is an Equal Opportunity Employer–Protected Veterans, Individuals with Disabilities or any other basis protected by law, ordinance, or regulation.

Guidehouse will consider for employment qualified applicants with criminal histories in a manner consistent with the requirements of applicable law or ordinance including the Fair Chance Ordinance of Los Angeles and San Francisco.

If you have visited our website for information about employment opportunities, or to apply for a position, and you require an accommodation, please contact Guidehouse Recruiting at 1-571-633-1711 or via email at RecruitingAccommodation@guidehouse.com. All information you provide will be kept confidential and will be used only to the extent required to provide needed reasonable accommodation.

All communication regarding recruitment for a Guidehouse position will be sent from Guidehouse email domains including @guidehouse.com or guidehouse@myworkday.com.  Correspondence received by an applicant from any other domain should be considered unauthorized and will not be honored by Guidehouse.  Note that Guidehouse will never charge a fee or require a money transfer at any stage of the recruitment process and does not collect fees from educational institutions for participation in a recruitment event. Never provide your banking information to a third party purporting to need that information to proceed in the hiring process.

If any person or organization demands money related to a job opportunity with Guidehouse, please report the matter to Guidehouse’s Ethics Hotline. If you want to check the validity of correspondence you have received, please contact recruiting@guidehouse.com. Guidehouse is not responsible for losses incurred (monetary or otherwise) from an applicant’s dealings with unauthorized third parties.

Guidehouse does not accept unsolicited resumes through or from search firms or staffing agencies. All unsolicited resumes will be considered the property of Guidehouse and Guidehouse will not be obligated to pay a placement fee.