Manager, Clinical Documentation Integrity

Overview

The Clinical Documentation Integrity Manager oversees the daily operations of the Carle Health CDI program which is inclusive of staff activities, data collection, analysis and reports in order to meet organizational goals. In conjunction with the HIM Director the CDI Manager ensures the quality, accuracy and timeliness of the CDI process and outcomes. This position is responsible for monitoring and optimizing case mix index, mortality and severity of illness metrics for Carle facilities and any required reporting for these metrics as well as monitoring compliance with regulatory requirements. The CDI manager assures consistent workflow with concurrent review of inpatient hospital encounters by hiring, training and maintaining sufficient staffing to meet program objectives.

 

The CDI Manager partners with the HIM physician advisors and medical staff leaders to identify education needs and develop education for providers related to clinical documentation integrity and the DRG system. Additionally, this position works in tandem with the hospital Coding Manager to assure DRG coding is accurate, coding queries are managed, and education is provided to the coding team related to CDI. The CDI Manager also partners with other Revenue Cycle leaders to trend and respond to inpatient denials as appropriate.

Responsibilities

• Manage the CDI team including but not limited to:
  • hiring, training, managing and evaluating team performance 
  • conducting professional development plans. 
• Ensure productivity and accuracy standards are met
• Support overall department and Carle organizational goals.
• Assist Director in budgeting for the CDI department. 
• Collect, analyze, present data, and solutions related to CDI team performance, provider performance, query outcomes and documentation issues across Carle. 
• Develop and execute CDI process improvement projects.
• Collaborate extensively with HIM physician advisors, Carle medical staff, vendors and coding leadership
• Provide data and solutions to further Carle's objectives related to the CDI program. 
• Oversees the development and implementation of ongoing formal and information education of the medical staff, coders, CDI, and other staff as needed related to CDI topics.
• Reviews and develops policies and procedures to support compliant CDI workflows.
• Develops reports as needed and communicates CDI metrics to internal and external teams as needed.
• Works with software vendor and external consulting groups 
• Ensure software efficacy
• Ensure integrity of the data from these teams and software applications
• Ensure vendor is compliant with contractual obligations.
• Participates in and leads multidisciplinary teams 
• develop and implement best practices in Clinical Documentation Improvement. 
• Provides feedback to Director of Coding and CDI on exceptional and substandard CDI performance as needed. 
• Provides support and guidance in all Carle Experience and Carle Behavior Standards initiatives.
• Presents CDI metrics as requested or required at department and external meetings.
• In conjunction with the coding managers evaluates ongoing requirements for coding and DRG assignment yearly.
• Provides support of and guidance in all Carle Experience and Carle Behavior Standards and Initiatives.

Qualifications

Certifications:

• Registered Health Information Administrator (RHIA) or 
• Certified Coding Specialist (CCS) or
• Licensed Registered Professional Nurse (RN) within 6 months - if licensed in another state 

Education:

• Bachelor's Degree: Nursing or  
• Bachelor's Degree: Health Information Administration 

Work Experience:

• Healthcare Management - 3 years 
• Inpatient Coding and/or Clinical Documentation - 3 years 

 

Additional Skills and Knowledge:

• Well versed in Microsoft Office tools (Excel)
• Well versed in Epic
• Up to date on all coding guidelines
• Familiar with Medicare coding guidelines and rules
• Excellent communication skills both verbal and written  

Carle Health Company Overview

Find it here.

 

Discover the job, the career, the purpose you were meant for. At Carle Health, we're committed to fostering a workplace where every team member feels valued, respected and empowered, where passion and purpose come together to positively impact the lives of our patients and our communities. Find it all at Carle Health.

 

Our nearly 17,000 team members and providers work together to support patient care across central and southeastern Illinois.  We’ve grown to include eight, award-winning hospitals and a multispecialty provider group with more than 1,500 doctors and advanced practice providers. We’re developing the next generation of providers and healthcare professionals through Carle Illinois College of Medicine, the world’s first engineering-based medical school, and Methodist College. Carle BroMenn Medical Center, Carle Foundation Hospital, Carle Health Methodist Hospital, Carle Health Proctor Hospital, Carle Health Pekin Hospital, and Carle Hoopeston Regional Health Center hold Magnet® designations, the nation’s highest honor for nursing care. We offer opportunities in several communities throughout central Illinois with potential for growth and life-long careers at Carle Health.

 

 

 

We are an Equal Opportunity Employer and do not discriminate against any employee or applicant for employment because of race, color, sex, age, national origin, religion, sexual orientation, gender identity, status as a veteran, and basis of disability or any other federal, state or local protected class. Carle Health participates in E-Verify and may provide the Social Security Administration and, if necessary, the Department of Homeland Security with information from each new employee's Form I-9 to confirm work authorization. | For more information: human.resources@carle.com.

Salary Range

The compensation range for this position is $44.99per hour - $77.38per hour. This represents a good faith minimum and maximum range for the role at the time of posting by Carle Health. The actual compensation offered a candidate will be dependent on a variety of factors including, but not limited to, the candidate’s experience, qualifications, location, training, licenses, shifts worked and compensation model. Carle Health offers a comprehensive benefits package for team members and providers. To learn more visit careers.carlehealth.org/benefits.