Director - Clinical Documentation Integrity - Remote

UnitedHealth Group • Latrobe, PA

10d • Remote

About The Position

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together.
The Service Area Director, Clinical Documentation Integrity directs the activities of the Clinical Documentation Integrity (CDI) department. The selected candidate is responsible for providing CDI program oversight and day-to-day implementation of processes related to the concurrent review of the clinical documentation in the inpatient medical record of Optum Insight client (Dignity Health) patients at multiple hospitals across the Dignity Central Coast and Central Valley regions. This includes, but is not limited to, overall responsibility for the planning, administration, control and quality management of the CDI Department activities in addition to regular reporting of department progress and initiatives to hospital leadership.
This position collaborates with providers and other healthcare team members to make improvements that result in accurate, comprehensive documentation that reflects completely, the clinical treatment, decisions, and diagnoses for the patient. This position utilizes clinical expertise and clinical documentation improvement practices and facility specific tools for best practice and compliance with the mission/philosophy, standards, goals and core values of Optum 360. The Service Area Director of CDI does not have patient care duties, does not have direct patient interactions, and has no role relative to patient care.
The CDI Service Area Director is involved in the education of all phases of the Clinical Documentation Improvement process across a service area. Provides ongoing Clinical Documentation Improvement education for physicians & new staff and new initiatives or identified areas of knowledge deficit. Tracks and trends program compliance to determine areas of focus for educational opportunities.
You’ll enjoy the flexibility to work remotely from anywhere within the U.S. as you take on some tough challenges. For all hires in the Minneapolis or Washington, D.C. area, you will be required to work in the office a minimum of four days per week.

Requirements

• Graduate of a state approved RN program, BSN required (for nurse applicants)
• Nurse (RN, NP), Physician (MD, DO, FMG), Physician Assistant (PA)
• CCDS or CDIP certification
• 4+ years of CDI experience in an acute inpatient setting
• 3+ years of Excel experience
• 2+ years of direct people management experience, with demonstrated leadership of people and projects
• Proven solid Analytical skills (with CDI metric related focus)
• Proven solid written and spoken communication abilities
• Willingness to travel up to 40%25

Nice To Haves

• CCS Certification
• Proven solid MS office skills
• Proven solid ability to influence key stake holders
• Located in EST or CST
• All employees working remotely will be required to adhere to UnitedHealth Group’s Telecommuter Policy

Responsibilities

• Operations, business, financial, and human resource needs of the CDI department
• Plan daily operations of the department in conjunction with the AVP of CDI and participates in development of objectives to meet KPI’s
• Direct and maintains adequate staffing and workflow to meet CDI needs
• Monitor various reports and productivity to ensure that production standards and objectives are met in areas of responsibility
• Lead the CDI program as demonstrated by assuming accountability for the ongoing success of the Clinical Documentation Program. Monitors CDI program and communicates with appropriate facility leadership regarding CDI key performance indicators (KPIs), and identifies and implements process changes to maintain and improve KPIs
• Engage and consult with Physician Advisor and/or CMO to resolve provider issues regarding answering clarifications and participation in the clinical documentation improvement process
• Serves as a resource to Physicians / Case Managers and other key professional staff in matters relating to clinical documentation improvement & ICD-10
• Works with medical records, quality, finance, and physician groups to develop systems to facilitate complete documentation for data reporting purposes
• Develops and monitors strategic operating goals, objectives and budget; and reports operational performance, justification and/or corrective action
• Develops and manages direct reports; and oversees the development and management of indirect reports
• Builds and maintains productive inter/intra departmental and vendor work relationships to optimize operations
• Oversees compliance with government and agency regulations
• Performs related duties, as required
• Provide ongoing Clinical Documentation Improvement education for providers & new staff and new initiatives or identified areas of knowledge deficit. Track and trend program compliance to determine areas of focus for educational opportunities
• This position will require frequent interaction with hospital leadership, clinical teams, Quality, Care Coordination, and other departments across multiple facilities and multiple client accounts
• Manage multiple projects simultaneously, manage cross-functional teams, and drive strategic initiatives
• Design and implements education programs which provide education for CDI staff
• Develop and conduct ongoing CDI education for new staff
• Participate in ongoing education of staff
• Communicate information effectively
• Monthly reporting of CDI program progress/operations to hospital leadership
• Responding to questions, concerns and requests promptly
• Serving as a resource regarding, policies/procedures/practices
• Identify areas of improvement/education through data collection, analysis, and reports. Participate on committees and conduct studies as necessary to demonstrate improvement in clinical documentation processes
• Interview, hire, provide leadership, counseling, training for employees in areas of responsibility
• Ensure new employees are oriented and trained in all job functions
• Perform counseling both verbal and written for employees requiring additional assistance as evidenced by communication in the personnel file
• Provide consultation to providers and other clinical professionals, and leads implementation of changes that result in improvements in the patient care team’s ability to provide appropriate and timely treatment, communication regarding the patient’s condition, patient’s response to treatment, severity of illness, risk of mortality and treatment complexity

Benefits

• comprehensive benefits package
• incentive and recognition programs
• equity stock purchase
• 401k contribution

What This Job Offers

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