drjobs Manager Clinical Documentation Integrity Performance

Manager Clinical Documentation Integrity Performance

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Job Location drjobs

Detroit, MI - USA

Monthly Salary drjobs

Not Disclosed

drjobs

Salary Not Disclosed

Vacancy

1 Vacancy

Job Description

The CDI Manager will lead a team of CDI Coders ensuring compliance with regulatory standards and optimizing clinical documentation practices. This role requires a strong commitment to regulatory compliance accuracy in coding and collaboration with stakeholders at various levels of healthcare operations.
The manager will be responsible for overseeing CDI coding processes ensuring alignment with national market practice and individual providerlevel requirements. They will work closely with CDI coders to maintain highquality documentation standards support accurate risk adjustment coding and facilitate workflow efficiencies.

This position offers a remote work environment with opportunities for periodic travel to practices for onsite training auditing and support. The ideal candidate is detailoriented servicedriven and an effective communicator with proficiency in Google Suite tools or a willingness to quickly master them

Primary Duties:

    • Plans organizes and manages the system wide CDI Coding performance functions. Manages the activities of and provides leadership to the CDI Coding team. People manage a team of 510 CDI Coders. Provide guidance and support and build effective teams (both internally and with vendors) to achieve established goals within established budgets.

    • Manage and monitor the effectiveness of the coding and billing programs; develop key indicators to effectively monitor performance and identify and implement process improvement strategies necessary to meet annual targets. Manages coding and quality productivity workflow and performance activities.

    • Acts as a liaison and subject matter expert for internal and external customers in coding billing and risk adjustment. Monitors coding performance to meet regulatory legal and risk management implications of health information coding and documentation compliance guidelines. Manages adherence to the policies and procedures governing coding and reimbursement in compliance with federal and state laws and regulatory guidelines.

    • Design build scale and oversee activities programs interventions and solutions based on market needs. Actively participates in the evaluation selection and maintaining of information systems supporting coding. Use data to identify practices that could benefit from Aledade services. Partner with practices to understand billing and coding workflows and identify opportunities for process improvement.

    • Manage & lead billing and coding related projects including tracking key metrics across initiatives and driving crossfunctional team collaboration. Identify trends across practices and provide feedback on the best course of action to improve billing and coding practices.

Minimum Qualifications:

    • Bachelors degree in Health Information Management or related healthcare field. 10 years of experience in lieu of the degree.
    • Minimum 46 years of experience in a health plan or health system setting
    • Minimum of 3 years of experience in Risk Adjustment
    • Minimum of 3 years of management experience
    • Ability to influence provide customer service and work collaboratively with internal and external customers including physicians
    • Ability to establish and maintain effective working relationships across the company
    • Complete understanding of acuity levels for specific patient populations and strong clinical knowledge with the ability to interpret clinical documentation
    • Critical thinking skills to problem solve and communicate with physicians on clinical issues
    • Analytical ability necessary to conduct basic research analyze and interpret data evaluate processes and propose solutions.
    • Extensive knowledge of regulations and guidelines pertaining to documentation and coding.
    • Ability to prioritize work meet deadlines and produce quality results on time with strong attention to detail.
    • Excellent written and oral communication skills including excellent presentation skills and the ability to communicate effectively with all levels of management and medical providers.

Preferred Key Skills and Abilities:

    • Masters degree in health related fields.
    • One of the following active credentials issued by the American Health Information Management Association (AHIMA) or current Registered Nurse (RN) licensee:
    • RHIA Registered Health Information Administrator
    • RHIT Registered Health Information Technician
    • RN Registered Nurse
    • One or more of the following active credentials:
    • Certified Coding Specialist (CCS) AHIMA
    • Certified Documentation Improvement Practitioner (CDIP) AHIMA
    • Certified Clinical Documentation and Certification Outpatient (CCDSO) ACDIS
    • Certified Risk Coder (CRC) AAPC
    • Certified Professional Medical Auditor (CPMA) AAPC
    • Certified Professional Biller (CPB) AAPC
    • Rural Health Coding & Billing Specialist (RHCBS) ArchPro Coding
    • Community Health Coding & Billing Specialist (CHCBS) ArchPro Coding

Physical Requirements:

    • Sitting for prolonged periods of time. Extensive use of computers and keyboard. Occasional walking and lifting may be required.
    • Flexibility to travel up to 10 of the time

Who We Are:
Aledade a public benefit corporation exists to empower the most transformational part of our health care landscape independent primary care. We were founded in 2014 and since then weve become the largest network of independent primary care in the country helping practices health centers and clinics deliver better care to their patients and thrive in valuebased care. Additionally by creating valuebased contracts across a wide variety of health plans we aim to flip the script on the traditional feeforservice model. Our work strengthens continuity of care aligns incentives and ensures primary care physicians are paid for what they do best keeping patients healthy. If you want to help create a health care system that is good for patients good for practices and good for society and if youre eager to join a collaborative inclusive and remotefirst culture youve come to the right place.

What Does This Mean for You
At Aledade you will be part of a creative culture that is driven by a passion for tackling complex issues with respect openmindedness and a desire to learn. You will collaborate with team members who bring a wide range of experiences interests backgrounds beliefs and achievements to their work and who are all united by a shared passion for public health and a commitment to the Aledade mission.

In addition to time off to support worklife balance and enjoyment we offer the following comprehensive benefits package designed for the overall wellbeing of our team members:

Flexible work schedules and the ability to work remotely are available for many roles
Health dental and vision insurance paid up to 80 for employees dependents and domestic partners
Robust timeoff plan 21 days of PTO in your first year)
Two paid volunteer days and 11 paid holidays
12 weeks paid parental leave for all new parents
Six weeks paid sabbatical after six years of service
Educational Assistant Program and Clinical Employee Reimbursement Program
401(k) with up to 4 match
Stock options
And much more!

At Aledade we dont just accept differences we celebrate them! We strive to attract develop and retain highly qualified individuals representing the diverse communities where we live and work. Aledade is committed to creating a diverse environment and is proud to be an equal opportunity employer. Employment policies and decisions at Aledade are based on merit qualifications performance and business needs. All qualified candidates will receive consideration for employment without regard to age race color national origin gender (including pregnancy childbirth or medical conditions related to pregnancy or childbirth) gender identity or expression religion physical or mental disability medical condition legally protected genetic information marital status veteran status or sexual orientation.

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Manager

Employment Type

Full-Time

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