Health Information Management (HIM) Manager - Onsite

ClearSky Health•Mansfield, TX

1d•Onsite

About The Position

The HIM Manager is responsible for maintaining the security, confidentiality, completeness, and accuracy of medical records in accordance with organizational policies, procedures, and regulatory requirements. The position may also serve as the Hospital Privacy Officer and oversees compliance efforts related to the Centers for Medicare & Medicaid Services (CMS) Review Choice Demonstration (RCD) and Final Rule Audit (FRA), acting as the primary onsite contact for related compliance initiatives. The HIM Manager integrates company values into daily practice. The role directs day-to-day HIM department activities, including indexing, transcription, quantitative analysis, chart completion, release of medical record information, and abstracting medical information. It oversees concurrent record completion and coordinates with hospital disciplines to ensure accuracy and adherence to the Final Rule. The manager serves as a Cerner superuser and source expert for auditing Final Rule elements and supporting providers. The HIM Manager oversees medical record assembly and completion, monitors staff and physician compliance with recordkeeping requirements, and works with RCD leadership and hospital staff on process improvement and education. The role develops, implements, and maintains privacy policies and procedures in coordination with Hospital administration, the Corporate Compliance Officer, and legal counsel. It safeguards confidentiality by ensuring release-of-information procedures are followed, securing legal and risk-management records, responding to subpoenas and court orders, and representing the Hospital in hearings or depositions as required. The position may also conduct initial and ongoing credentialing for Hospital medical staff. Once the Hospital is formally under the Review Choice Demonstration, the role follows established protocols for Medicare affirmations and timely responses to non-affirmations; stays informed about changes to RCD/FRA processes; communicates admission non-affirmations or denials and assists with justifications; supports appeals by synthesizing clinical documentation into service justifications for all payors; and manages tracking systems to meet deadlines and provide real-time admission data. The HIM Manager promotes safety for patients, visitors, and staff, assesses risks, follows approved safety and Infection Prevention standards, completes assigned training, and performs other duties that support organizational effectiveness.

Requirements

At least two years of medical records experience.
A degree in Health Information Management or a related subject.
Knowledge of information privacy laws, including 45 CFR, HIPAA, and state medical-records law.
Working knowledge of general hospital operations.
Knowledge of accreditation standards and requirements established by state agencies, The Joint Commission (TJC), and CMS.
Understanding of treatment costs and financial support as they relate to quality and efficiency.
Working knowledge of medical terminology, abbreviations, and spelling.
Ability to maintain exceptional confidentiality.
Proficiency with general computer skills, including data entry, word processing, email, and records management.
Critical-thinking skills.
Ability to prioritize, meet deadlines, and complete complex tasks.
Ability to maintain quality and safety standards.
Ability to work closely and professionally with people at all organizational levels.
Effective organizational and time-management skills.
Ability to travel as needed.
Ability to sit, walk, bend, reach, lift, and carry, often for prolonged periods; lift or exert up to 10 pounds; operate equipment and a computer keyboard with sufficient manual dexterity; maintain close vision and adjust focus; and hear overhead pages.

Nice To Haves

Two years of medical coding experience.
Experience in a management role.
A degree from a CAHIIM-accredited program.
RHIA or RHIT certification.
CCS certification as an additional credential.

Responsibilities

Direct, plan, schedule, and participate in daily HIM department activities, including indexing, transcription, quantitative analysis, chart completion, release of medical record information, and abstracting medical information.
Oversee concurrent medical record completion and collaborate across disciplines to ensure accuracy and adherence to the Final Rule.
Serve as the Cerner superuser and source expert for auditing Final Rule elements, and support providers using Cerner.
Direct record assembly and review medical records for required chart-completion data elements.
Monitor and evaluate physicians and hospital staff for compliance with recordkeeping requirements.
Oversee development, implementation, maintenance, and adherence to patient-health-information privacy and access policies and procedures.
Collaborate with RCD leadership and hospital staff on process improvement and education related to documentation and timeliness.
Provide guidance on information privacy policies and procedures in coordination with Hospital administration, the Corporate Compliance Officer, and legal counsel.
Safeguard medical-record confidentiality by ensuring release-of-information policies are followed, securing legal and risk-management records, responding to subpoenas and court orders, and representing the Hospital in hearings or depositions as required.
May perform initial and ongoing credentialing for Hospital medical staff.
Promote safety, assess risks, implement appropriate precautions, and comply with approved safety and Infection Prevention standards.
Complete required assigned training and perform other duties supporting organizational effectiveness.
When the Hospital is formally under RCD, follow protocols for Medicare affirmations and timely responses to non-affirmations.
Stay informed about RCD/FRA process changes, regional MAC approaches, and review outcomes.
Communicate reasons for admission non-affirmations or denials to Hospital and RCD leadership and assist with justifications.
Assist with denials through the appeal process, including synthesizing clinical documentation into justifications for services for all payors.
Manage tracking systems to meet deadlines and provide real-time admission data for timely submissions.