Clinical Documentation Intergrity Manager

Valleywise Health • Phoenix, AZ

18h • Hybrid

About The Position

The Clinical Documentation Integrity (CDI) Manager provides clinical and administrative leadership to inpatient and outpatient CDI teams under the direction of the HIM Director. The manager oversees staff management and development, quality, service excellence, workplace experience, and financial outcomes, and partners with organizational leadership to improve provider documentation. The position is accountable for delegated responsibilities and works both remotely and onsite in ambulatory clinics and the Inpatient Acute Hospital. It routinely involves using a personal vehicle to travel to assigned ambulatory clinic sites to provide formal and informal education to providers.

The manager oversees CDI program productivity, quality, education and training, auditing, reporting, performance improvement, and standardized practices, processes, policies, and procedures. The role tracks and reports risk-adjusted HCC capture rates and RAF accuracy in alignment with managed care contracts, particularly Medicare Advantage plans. It also supports accurate documentation, coding, reporting, facility and physician profiling, acuity capture, reimbursement, and compliance.

Requirements

• Bachelor of Science in Nursing, a master’s degree in Medicine, or an equivalent combination of training and progressively responsible experience providing the specialized knowledge and abilities for the work.
• Five years of clinical documentation improvement experience, including at least two years of supervisory or managerial activity.
• At least ten years of direct clinical experience.
• Hands-on experience with the EPIC Electronic Health Record, 3M encoder, and Microsoft Office software.
• Current licensure to practice as a Registered Nurse in Arizona or compact state licensure.
• Valid driver’s license.
• Professional certification in Clinical Documentation (CCDS or CDIP).
• Ability to understand computer applications, Microsoft Office (Excel, Word, PowerPoint, and Outlook), electronic health records, and encoder systems.
• Ability to abide by AHIMA and AAPC Standards of Ethical Coding.
• Analytical ability to interpret clinical data in records and assign appropriate codes.
• Ability to show initiative and use critical thinking to develop potential solutions to identified problems.
• Proficiency in developing and presenting education programs.
• Effective communication and excellent customer service skills.
• Ability to work independently and make independent decisions.
• Ability to analyze and prioritize work and organize and coordinate multiple functions and tasks.
• Ability to read, write, and speak effectively in English.

Nice To Haves

• Professional Certification (CRC).
• Coding credentials (CCS, CCS-P, CPC, CIC, or COC), or RHIA or RHIT certification with requisite coding experience.
• Dual credentials.

Responsibilities

• Provide clinical and administrative leadership to inpatient and outpatient CDI teams.
• Manage staff development, quality, service excellence, workplace experience, and financial outcomes.
• Oversee CDI program productivity, quality, education and training, auditing, report management, performance improvement initiatives, and standardized practices, processes, policies, and procedures.
• Manage and report risk-adjusted HCC capture rates and RAF accuracy in alignment with managed care contracts, particularly Medicare Advantage plans.
• Track and trend metrics and periodically present CDI compliance and progress related to HCC diagnosis capture to physicians.
• Promote accurate capture of bedside care in documentation and corresponding reporting codes, supporting accurate reporting, profiling, and acuity capture.
• Audit documentation quality to support accurate statistics and reimbursement for inpatient and outpatient CDI programs.
• Maintain working knowledge of CDI technology tools for data entry, report generation, and tracking.
• Approve CDI time sheets, complete performance evaluations, develop performance improvement plans when necessary, and monitor compliance learning module completion.
• Lead or support initiatives involving DRG downgrade denials, State Fair Hearing appeals, PSI reporting, physician education, ICD-10 preparedness, and implementation.
• Assist in developing system-wide CDI policies and procedures that meet Corporate Compliance guidelines and support appropriate, effective reimbursement.
• Provide formal and informal education to ambulatory clinic providers at assigned sites.
• Work both remotely and onsite in ambulatory clinics and the Inpatient Acute Hospital.

What This Job Offers

• Job Type: Full-time
• Career Level: Manager