Sr Manager - Clinical Documentation Integrity

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This is a Stanford Health Care job.

A Brief Overview
This position facilitates the vision and CDI program strategy as determined in partnership and as identified by the CDI director. Focusing on operational performance projects innovations and process improvement opportunities. Manages daily operational management of the CDI program and members within the designated team. This position evaluates the adequacy and effectiveness of internal and operational controls designed to ensure that CDI processes and practices lead to appropriate of regulatory requirements and guidelines related to Hospital Billing and/or Professional Billing coding and CDI practices including federal and state compliance standards.

This position plays a key role in leading the initiative for reporting quality of care outcomes and in obtaining complete accurate and compliant documentation for appropriate reimbursement of services provided and capture of clinical outcome measures.

Uses clinical coding and CDI expertise to analyze interpret and optimize CDI coding and outcomes performance through initiatives at the service line level in very close partnership with quality coding and IT.

Manages and is a key participant in multidisciplinary and highprofile projects related to CDI documentation and outcomes performance at the departmental and organizational levels.

Leads and coordinates team efforts in clinical documentation integrity programs and outcomes optimization relationship development and management optimization of educational strategy.

This position plays a key role in leading the initiative for reporting quality of care outcomes operational and organizational process improvement technology optimization through CDI departmental initiatives and industry leading practices.

Locations
Stanford Health Care

What you will do

• Team Oversight:

• Manages Documentation Specialists Supervisor and/or CDI Leads including activities such as goal setting annual Performance Appraisal coordinating scheduled timeoff allocating resources to cover the program throughout the hospital.

• CDI Quality:

• Manages the CDI accuracy/quality program including the analysis of the findings related performance improvement and optimization mitigation plans focused on continuous improvement to meet strategic goals and KPIs.

• Management of CDI audit programs and analysis of the findings related to documentation and coding to build physician engagement and multidisciplinary partnerships identifying areas of individual and team opportunity and facilitate short and longterm resolutions.

• Program Development:

• Coordinates the development of clinical documentation programs to improve the accuracy of documentation and the quality of patient care reported.

• Leads multidisciplinary and multidepartmental documentation initiatives to achieve strategic goals and objectives.

• Optimizes medicalcenterwide clinical documentation integrity program teams with guidance from CDI director

• Subject Matter Expert:

• Serve as a subject matter expert and authoritative resource on interpretation and application of CDI practices coding rules and regulations and conducts risk assessments of potential and detected compliance deficiencies as well as documentation improvement opportunities.

• Acts as a consultant to quality managers coding leadership management team medical staff and health care staff regarding outcome and coderelated data performance and clinical documentation opportunities

• Acts as expert in the areas of ambiguous or conflicting information in the medical record CDI practices CDI innovation coding outcome performance impact and optimal resource utilization

• Developing Partnerships:

• Manages relationships with key organizational and industry partners including quality compliance coding case management clinical providers other multidisciplinary teams.

• Coordinates the development of working sessions of multidisciplinary teams in goal setting and problem solving.

• Responsibility for management and optimization of the positive relationships between CDI and business partners and customers across a variety of teams and roles.

• Analytics & Process Improvement:

• Coordinates data collection and analysis in collaboration with quality teams related to patient care activities documentation opportunities coding opportunities and clinical outcome performance gaps.

• Leads and manages departmental portfolio of multidisciplinary and multidepartmental CDI projects to achieve strategic goals and objectives.

• Partners with key leaders within IT and other related areas to create and optimize documentation tools process and strategies to reduce administrative burden on our providers while maintaining high quality and integrity documentation.

Education Qualifications

• Bachelors Degree in Nursing Medicine Health Information Management or similarly related field of study

• Masters Degree preferred

• At least one currently active:
  CCDS CCDSO CDEO CDEI or CDIP certification or similar CDI certification

• At least two currently active:
  COC CPC CIC CRC CPMA or CCS certification or similar
  Revenue cycle certification (CRCR CSPR CSPPM etc) or similar
  Health Care Quality (HACP CPHQ HCQM) certification or similar
  Case Management utilization review and/or safety Certification (CCM HCQM CMGTBC CPUR CPPS CPHRM CCMC) or similar
  Health Information Certification (RHIT RHIA CEHRS)
  Clinical research certification (ACRPCP CCRA CCRC CPI ACRPMDP etc) or other research certification
  Physician Educator Certificate Program (PECP) certification Certified Nurse Educator (CNEcl CNE ACE etc) AHIMA approved trainer certification (ICD10 CM ICD10 CM/PCS or CDI) or other education certification
  Project Management (CAPM PMP ACRPPM) or other project management certification or similar
  Process/performance improvement certification (Lean Six Sigma CHPI CPT etc) or similar
  Analytics and/or data management certification (CAP CDMP CHRS CSBI) or similar
  EHR (Epic CEHRS 3M/Solventum) certification or other medical technology certification
  Privacy Compliance and/or Security (CPHS CHPSE HCISPP RUHD CHC CHPC CPCO) certification or similar

Experience Qualifications

• Five 5 years of progressively responsible and directly related inpatient clinical experience data analytical experience or inpatient coding/revenue cycle experience and

• At least 5 years of direct CDI related work experience and

• Three 3 years of supervisory/management responsibility preferred

Required Knowledge Skills and Abilities

• Demonstrates ability to analyze problems and issues and understand the regulatory reimbursement and outcomes performance impact of those decisions.

• Demonstrates critical thinking skills able to assess evaluate and teach.

• Demonstrates knowledge of and application of AHIMA and ACDIS Ethical Standards.

• Ability and willingness to seek out and accept change.

• Expertise in MSDRGs ICD10 coding Quality and other performance comparison data bases (Vizient etc) and CDI practices required.

• Expertise in industryleading CDI practices and knowledge distribution to multidisciplinary teams.

• Proficiency with Microsoft Applications including word processing spreadsheets and presentation software.

• Extensive knowledge and experience in reporting software electronic medical record systems CDI/Coding software AI technology and the optimization of technology tools within the CDI context.

• Demonstrated leadership ability.

• Maintains industry leading knowledge of CDI Coding and outcomes performance management within the context of regulatory compliance and industry best practice rules and regulations regarding CDI and coding.

• Ability to work with senior management physicians and medical center staff with various levels of education and experience.

• Ability to develop and maintain strong collaborative and supportive working relationships with CDI peers physicians and other clinical professionals.

• Must have demonstrated effective interpersonal verbal and written communication skills in dealing with multidisciplinary teams and variety of ongoing activities.

• Knowledge of project management processes and systems.

• Skilled and experienced in data and statistical analysis and reporting practices pertaining to quality improvement and program evaluation including qualitative reporting of results.

• Demonstrated organizational project management skills.

• Ability to work independently creatively and innovationfocused in highvolume fast paced and highly political work environments.

• Ability to lead teams and manage highprofile projects to produce results within schedule and budget.

• Ability to plan organize motivate mentor direct and evaluate the work of others.

• Demonstrated leadership ability organizational savviness and critical thinking skills.

• Ability to work effectively with individuals at all levels of the organization.

• Demonstrated organizational and critical thinking skills ability to assess evaluate and teach.

• Ability to provide advice and counsel clients/customers on a broad range of CDI coding outcomes and documentation matters regarding effectiveness compliance and efficiency.

• Knowledge of analytical research procedures and methods.

• Ability to assess data and reporting tools or make recommendations regarding their improvement or enhancement.

• Ability to provide concise reports of activities and results.

• Ability to successfully navigate multiple projects and responsibilities

• Ability to develop and maintain strong collaborative and supportive working relationships with peers physicians and other clinical professionals.

• Knowledge of statistical analysis and reporting practices pertaining to quality improvement and program evaluation.

• Ability to work independently in performing duties with minimal supervision with a high degree of selfmotivation.

• Expertise in developing and delivering training and education to clinical CDI and coding professionals regarding CDI practices coding and documentation requirements as well as knowledge distribution to multidisciplinary teams.

These principles apply to ALL employees:

SHC Commitment to Providing an Exceptional Patient & Family Experience

Stanford Health Care sets a high standard for delivering value and an exceptional experience for our patients and families. Candidates for employment and existing employees must adopt and execute CICARE standards for all of patients families and towards each other. CICARE is the foundation of Stanfords patientexperience and represents a framework for patientcentered interactions. Simply put we do what it takes to enable and empower patients and families to focus on health healing and recovery.

You will do this by executing against our three experience pillars from the patient and familys perspective:

• Know Me: Anticipate my needs and status to deliver effective care

• Show Me the Way: Guide and prompt my actions to arrive at better outcomes and better health

• Coordinate for Me: Own the complexity of my care through coordination

Equal Opportunity Employer Stanford Health Care (SHC) strongly values diversity and is committed to equal opportunity and nondiscrimination inall ofits policies and practices including the area of employment. Accordingly SHC does not discriminate against any person on the basis of race color sex sexual orientation or gender identity and/or expression religion age national or ethnic origin political beliefs marital status medical condition genetic information veteran status or disability or the perception of any of the above. People of all genders members of all racial and ethnic groups people with disabilities and veterans are encouraged to apply. Qualified applicants with criminal convictions will be considered after an individualized assessment of the conviction and the job requirements.

The salary of the finalist selected for this role will be set based on a variety of factors including but not limited to internal equity experience education specialty and training. This pay scale is not a promise of a particular wage.