Job Description

Facility: Valleywise Health Medical Center

Department: Health Information Management - Coding

Schedule: Regular FT 40 Hours Per Week

Shifts: Days

Utilizing a hybrid work environment, under the direction of the HIM Director, the CDI Manager provides clinical and administrative leadership to the inpatient and outpatient CDI teams. Responsible for staff management and development, quality, service excellence, workplace experience, and financial outcomes. Partners with organizational leadership to achieve goals to improve provider documentation. Assumes accountability as delegated by the HIM Director.

Annual Salary Range: $105,164.80 - $155,126.40

Qualifications
Education:

• Requires a Bachelor of Science in Nursing or a master’s degree in Medicine; or an equivalent combination of training and progressively responsible experience that will result in the required specialized knowledge and abilities to perform the assigned work. 

Experience:

• Required: Five (5) years of experience in clinical documentation improvement including at least two (2) years of supervisory/managerial level activity. 
• Required: Minimum of ten (10) years of direct clinical experience required.

Specialized Training:

• Required: Hands-on Experience with EPIC Electronic Health Record & 3M encoder and Microsoft Office software.

Certification/Licensure:

• Required: Current licensure to practice as a Registered Nurse in the State of Arizona or compact state licensure
• Required: Valid driver’s license
• Required: Professional certification in Clinical Documentation (CCDS or CDIP)
• Required: Professional Certification (CRC) within 30 months
• Preferred: Coding Credentials (CCS, CCS-P, CPC, CIC, COC) or RHIA, RHIT certification also accepted with requisite coding experience. 
• Preferred: Dual credentials

Knowledge, Skills, and Abilities:

• Manages daily CDI program oversight to include productivity, quality, education and training, auditing, report management, performance improvement initiatives, and developing standardized practices, processes as well as policies and procedures.
• Manages and reports risk-adjusted Hierarchical Condition Category (HCC) capture rate and Risk Adjustment Factor (RAF) accuracy in alignment with managed care contracts, particularly Medicare Advantage plans. Tracks/trends metrics and on occasion, presents CDI program compliance and progress related to capturing HCC diagnoses to the Physicians.
• Advocates for facilitating the best practice model for CDI, linking the most accurate capture of documented bedside care to the most accurate numeric reporting codes thereby, conversion into correct reporting, facility and physician profiling, and acuity capture.
• Audit’s documentation quality to support accurate statistics and reimbursement for the inpatient and outpatient CDI program. 
• Maintain a clear working knowledge of the CDI technology tool regarding data entry, report generation, and tracking methods to ensure the most efficient use of the tool.
• Approves CDI timesheets, completes performance evaluations, develops team member performance improvement plans if necessary, and monitors compliance learning module completion.
• Acts in a leadership capacity with key areas for initiatives such as DRG Downgrade Denials, State Fair Hearing Appeals, PSI reporting, Physician education, ICD-10 preparedness, and implementation.
• Assists in the development of policies and procedures for system-wide CDI practices to meet Corporate Compliance guidelines and to ensure appropriate and effective reimbursement.
• Must have a high level of understanding of computer applications, Microsoft Office (Excel, Word, PowerPoint, and Outlook), Electronic Health Records, and encoder systems.  
• Must be able to abide by the Standards of Ethical Coding as set forth by the American Health Information Management Association (AHIMA) and AAPC.
• Must have the analytical ability necessary to interpret clinical data contained in records and to assign appropriate codes. 
• Must have the ability to show initiative and utilize critical thinking skills to provide potential solutions to problems identified.
• Proficient in developing and presenting education programs.
• Must be able to communicate effectively and have excellent customer service skills. 
• Requires the ability to work well independently and demonstrate independent decision-making abilities.   
• Ability to analyze and prioritize work efforts and organize and coordinate multiple functions and tasks.
• Requires the ability to read, write, and speak effectively in English.
• Requires the ability to work both remotely and on-site in ambulatory clinics and Inpatient Acute Hospitals. 
• Utilizes personal vehicle to routinely travel to assigned ambulatory clinic sites to provide formal and informal education to ambulatory clinic providers.

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