Manager, Clinical Documentation Integrity Operating Unit

Organization:

Bay Administration

Position Overview:

Responsible for coordinating the day-to-day operations and workflow of the program. Responsible for ensuring optimized staffing, productivity, and education efforts in their market to support overall program performance metrics. Responsible for new staff onboarding, periodic employee reviews including annual evaluations, and leave requests. Tracks the professional development and educational needs for all team members. Facilitates leadership initiatives through the creation and delivery of task force activities and serves an active role in departmental meetings with key system stakeholders. Demonstrates excellent working knowledge of CDI program metrics, experience with preparing reports, and designs and reports on departmental dashboards.

Job Description:

EDUCATION:

Bachelor's: Nursing

Master's in Healthcare (MPH, MHA, MS, MBA, etc.)


CERTIFICATION & LICENSURE:

RN-Registered Nurse of California

OR MD-Medical Doctor

OR DO-Doctor of Osteopathy

OR Foreign trained physician

CCS-Certified Coding Specialist within 1 year

CCD or CDIP-Clinical Documentation Improvement Certification

TYPICAL EXPERIENCE:

5 years recent relevant experience


SKILLS AND KNOWLEDGE:

Knowledge of Pathophysiology and Disease Processes sufficient to pass the clinical pre-employment test at a rate of 85% or better is required.

Knowledge of Federal regulatory rules regarding documentation and coding desirable.

Up-to-date knowledge of ICD-10 mandate and the impact of code set transition, including potential impact on data quality for prospective payments, utilization, and reimbursement. Knowledge of ICD-10 desirable.

Strong Organization and Quantitative Analysis skills including spreadsheet applications and statistics.

Excellent verbal and written communication skills required.  Must be able to communicate effectively with a diverse group of individuals and departments, including members of the medical staff.

Dependable with a demonstrated ability to efficiently and independently manage own time and tasks with minimal supervision.

Willingness to act and dress in a professional manner at all times.

Able to manage multiple priorities and meet productivity targets

Critical thinking, problem solving and deductive reasoning skills

Demonstrated familiarity and adept use with software and technical applications including but not limited to: Microsoft Office products (Outlook, Excel, Word, PowerPoint) and Epic (Electronic Health Records).

Understand and support CDI documentation strategies

Ability to understand and communicate differences between Medicare Part A and Part B guidelines and how they impact DRG assignments (upon completion of training)

High degree of hospital coding knowledge, including but not limited to APR-DRG, MS-DRG, HCCs, Medicare, Medicaid & Managed Care, in order to design and develop strategies to yield improvements to documentation that will improve overall patient quality, capture severity, assess acuity and determine risk of mortality.

Thorough knowledge of clinical documentation requirements, clinical procedures, disease processes, treatments, and the patient populations served.

Subject matter expertise regarding quality and reimbursement implications of clinical documentation and coding.

Provides constructive feedback and promotes team collaboration along with guidance and CDS mentorship.

Collaborate to perform root cause analysis and assist with ongoing opportunities for process improvement.

Reviews HAC/PSI database content weekly to support CDS account review

Works in tandem to provide clear communication and expectations.

Identify areas of improvement and communicate improvement strategies to hospital leadership.

Ability to provide leadership including innovation, relationship building, conflict management, and strategic thinking.

Pay Range: $85.83-$137.33/ hour

Job Shift:

Days

Schedule:

Full Time

Shift Hours:

8

Days of the Week:

Friday, Monday, Thursday, Tuesday, Wednesday

Weekend Requirements:

None

Benefits:

Yes

Unions:

No

This position is work from home eligible.

Position Status:

Exempt

Weekly Hours:

40

Employee Status:

Regular

Number of Openings:

1

Sutter Health is an equal opportunity employer EOE/M/F/Disability/Veterans.

Pay Range is $100.72 to $161.15 / hour

The salary range for this role may vary above or below the posted range as determined by location. This range has not been adjusted for any specific geographic differential applicable by area where the position may be filled. Compensation takes into account several factors including but not limited to a candidate’s experience, education, skills, licensure and certifications, department equity, training and organizational needs. Base pay is just one piece of the total rewards program offered by Sutter Health. Eligible roles also qualify for a comprehensive benefits package.

Qualified applicants with arrest and conviction records will be considered for employment. Applicants for specific positions are still required to disclose certain convictions during the application process, and those convictions may also be considered in determining eligibility for employment in accordance with applicable law.

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