Health Information Management (HIM) Manager

Gunnison Valley Health

3d•Onsite

About The Position

We are committed to improving the health of our community by delivering exceptional care and services. As the leader of the team in Health Information Management (HIM) you will oversee the day-to-day operations of the Medical Records Department by ensuring timely completion, maintenance and security of all patient records in compliance with HIPAA, State Regulations, and accreditation standards. You will monitor and drive improvement in physician chart completion rates and delinquent medical record metrics. You will manage all Release of Information (ROI) processes, ensure ROI activities are processed with required timeframes, monitor ROI timeframes and implement process improvement as needed. You will lead and oversee the CDI program, supervise CDI specialists, develop and deliver provider education on requirements, and track CDI program metrics to report to Revenue Cycle Director and CFO. You will design and manage an internal coding audit program to ensure compliance with coding guidelines, payer requirements, and CMS regulations — serving as an objective checks-and-balance function independent of day-to-day coding operations. You will manage all external audit activity including RAC (Recovery Audit Contractor), MAC (Medicare Administrative Contractor), OIG, and commercial payer audits. You will oversee and manage the relationship with external vendors to ensure accurate, compliant and timely services that support the organization's revenue cycle performance. You will provide direct supervision, performance management, and professional development for HIM and CDI staff. You will collaborate with Coding, Billing, Finance, Compliance, and Clinical Operations teams to resolve documentation, coding, and billing issues. You will prepare and present HIM/CDI/audit performance dashboards and KPI reports to the Director of Revenue Cycle and CFO. You will serve as Subject Matter Expert (SME) for HIM-related issues during accreditation surveys (TJC, DNV, HFAP, or CMS CoP).

Requirements

Bachelor’s or Master’s Degree in Business Administration, or Healthcare Administration preferred. Associate Degree – Minimum 5 years of progressive HIM experience, with at least 2 years in supervisory or management role required.
Five years progressive HIM experience with at least 2 years supervisory or management role.
Demonstrated experience managing Release of Information operations and HIPAA compliance.
Hands on experience with CDI programs including query management and CMI analysis.
Direct experience managing external audits (RAC, MAC, OIG, or commercial payer audits.)
Experience with internal coding compliance auditing and corrective action program development.
Experience in a CAH or rural hospital setting preferred.
Working knowledge of ICD-10-CM/PCS, CPT and HCPCS Level II coding systems.
Familiarity with EHR platforms (EPIC)
Registered Health Information Advisor (RHIA), Registered Health Information Technician (RHIT) with progressive management experience required.
Preferred Certifications: Certified Clinical Documentation Specialist (CCDS) or Certified Documentation Improvement Practitioner (CDIP) Certified Coding Specialist (CCS) or Certified Professional Coder (CPC), Certified in Healthcare Compliance (CHC)

Nice To Haves

Experience in a CAH or rural hospital setting preferred.
Certified Clinical Documentation Specialist (CCDS) or Certified Documentation Improvement Practitioner (CDIP)
Certified Coding Specialist (CCS) or Certified Professional Coder (CPC)
Certified in Healthcare Compliance (CHC)

Responsibilities

Oversee the day-to-day operations of the Medical Records Department by ensuring timely completion, maintenance and security of all patient records in compliance with HIPAA, State Regulations, and accreditation standards
Monitor and drive improvement in physician chart completion rates and delinquent medical record metrics
Manage all Release of Information (ROI) processes, ensure ROI activities are processed with required timeframes, monitor ROI timeframes and implement process improvement as needed.
Lead and oversee the CDI program, supervise CDI specialists, develop and deliver provider education on requirements, and track CDI program metrics to report to Revenue Cycle Director and CFO
Design and manage an internal coding audit program to ensure compliance with coding guidelines, payer requirements, and CMS regulations — serving as an objective checks-and-balance function independent of day-to-day coding operations.
Manage all external audit activity including RAC (Recovery Audit Contractor), MAC (Medicare Administrative Contractor), OIG, and commercial payer audits.
Oversee and manage the relationship with external vendors to ensure accurate, compliant and timely services that support the organization's revenue cycle performance
Provide direct supervision, performance management, and professional development for HIM and CDI staff.
Collaborate with Coding, Billing, Finance, Compliance, and Clinical Operations teams to resolve documentation, coding, and billing issues.
Prepare and present HIM/CDI/audit performance dashboards and KPI reports to the Director of Revenue Cycle and CFO.
Serve as Subject Matter Expert (SME) for HIM-related issues during accreditation surveys (TJC, DNV, HFAP, or CMS CoP).

Benefits

Competitive salary
Generous and affordable medical/dental/vision plan
Dollar for dollar 401(a) match, up to 3%
Up to $250 in your first year toward your unique Lifestyle Spending Account
Matched retirement starting on day 1
Dependent care matching plan
Continuing education
Robust tuition reimbursement plan
Paid time off benefits with an accrual rate of 10.77% in your first year of employment
Access to mental health, financial health and wellness as well as life coaching with our Employee Assistance Program
Free nutrition consultations
Discounted fitness membership at Western Colorado University Fieldhouse
Deep discounts on food and drink in the cafeteria