Supervisor Clinic & Coding Quality

 Posted 2 days ago
     
5-10 years experience
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AI Summary

Provides operational leadership and oversight for clinical and coding quality workflows to ensure accuracy in risk adjustment and DRG integrity. Manages a team of analysts, monitors performance metrics, and serves as the primary escalation point for complex coding and CDI questions.
WHY UT SOUTHWESTERN?
With over 75 years of excellence in Dallas-Fort Worth, Texas, UT Southwestern is committed to excellence, innovation, teamwork, and compassion. As a world-renowned medical and research center, we strive to provide the best possible care, resources, and benefits for our valued employees. Ranked as the number 1 hospital in Dallas-Fort Worth according to U.S. News & World Report, we invest in you with opportunities for career growth and development to align with your future goals. Our highly competitive benefits package offers healthcare, PTO and paid holidays, on-site childcare, wage, merit increases and so much more. We invite you to be a part of the UT Southwestern team where you'll discover a culture of teamwork, professionalism, and a rewarding career!

JOB SUMMARY
The Clinical and Coding Quality Supervisor provides direct operational leadership and subject matter oversight for all daily clinical and coding quality workflows and assignments. This role is responsible for ensuring the accuracy, consistency, and effectiveness of second-level coding quality review workflows that support risk adjustment, DRG integrity, regulatory compliance, and institutional quality and financial performance. Promote and support Teamwork and engagement, performance excellence, accountability and professionalism. Lead and support process improvement. Ensure the Clinical & Coding Quality Team have the education and tools they need to successfully perform to the highest levels of quality and compliance.

BENEFITS
UT Southwestern is proud to offer a competitive and comprehensive benefits package to eligible employees. Our benefits are designed to support your overall wellbeing, and include:

  • PPO medical plan, available day one at no cost for full-time employee-only coverage
  • 100%25 coverage for preventive healthcare-no copay
  • Paid Time Off, available day one
  • Retirement Programs through the Teacher Retirement System of Texas (TRS)
  • Paid Parental Leave Benefit
  • Wellness programs
  • Tuition Reimbursement
  • Public Service Loan Forgiveness (PSLF) Qualified Employer
  • Learn more about these and other UTSW employee benefits!


EXPERIENCE AND EDUCATION

Required
  • Education
    Associate's Degree in nursing or health information management
  • Experience
    5 years of experience working in an Acute Hospital setting preferably in an Academic environment. An equivalent combination of education and experience may be considered and
    3 years to 5 years‿ experience working in a Quality/Risk Program. An equivalent combination of education and experience may be considered and
    Experience utilizing methodology-specific risk calculators and guidance documents to understand if additional diagnoses and/or risk variables will impact the reported quality impact of a specific patient encounter and
    Experience working in a remote environment
  • Licenses and Certifications
    Registered Health Information Management (RHIA), Registered Nurse (RN) with Certified Clinical Documentation Specialist (CCDS), Registered Health Information Technology (RHIT), or AHIMA Certified Coding Specialist (CCS)
Preferred
  • Education
    Bachelor's Degree in nursing or health information management

JOB DUTIES
  • Manages staffing and all employee related duties.
  • Provide day-to-day supervision of Coding Quality Analysts, including work assignment, prioritization, performance monitoring, and issue resolution.
  • Oversee all quality workflow and assignments:
  • Ensure quality changes are completed within revenue cycle goals and corrections are completed within deadlines.
  • Serve as the primary escalation point for complex CDI, coding, DRG, and risk-adjustment questions requiring advanced review.
  • Oversee coding quality audits validating ICD-10-CM/PCS code assignment accuracy, abstracted data accuracy (POA, discharge disposition, point of origin, admit type, PSI‿s), completion and implementation of coding audit recommendations across systems (Epic, 3M, eValuator) and ensure audit findings and recommendations are accurately implemented in final coded data sets.
  • Track, trend, and report quality metrics, including error rates, rework, and risk-adjustment performance (Vizient, HCC‿s, Elixhauser) to Leadership (Direct Manager, Coding and Quality Director, Coding and CDI Managers, Physician Advisors, etc.)
  • Identify front-end workflow issues impacting coding quality and recommend process improvements, deliver targeted education based on audit outcomes.
  • Collaborate with Denials Team processes and initiatives.
  • Maintains an expert level of knowledge of Coding, CDI, Denials, and Appeal guidelines and practices.
  • Onboards, trains, and audits all direct reports
  • Support the Quality Standards set by UTSW & the Coding Quality & Integrity Department.
  • Other duties as assigned.

SECURITY AND EEO STATEMENT

Security
This position is security-sensitive and subject to Texas Education Code 51.215, which authorizes UT Southwestern to obtain criminal history record information.

EEO
UT Southwestern Medical Center is committed to an educational and working environment that provides equal opportunity to all members of the University community. As an equal opportunity employer, UT Southwestern prohibits unlawful discrimination, including discrimination on the basis of race, color, religion, national origin, sex, sexual orientation, gender identity, gender expression, age, disability, genetic information, citizenship status, or veteran status.

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