Manager, Ambulatory Clinical Documentation Integrity (Remote)

Trinity Health•Livonia, MI

13d•Remote

About The Position

Purpose Accountable for leading, guiding & directing the functional responsibilities within an area of assignment. Enable ministry-level or enterprise-wide functional strategy to address internal or external business & regulatory issues. Provide functional expertise & ensure fulfillment of performance & service standards. Responsible for consistent operating performance & achieving financial goals. Identifies, defines & solves complex problems that impact the management & direction of the business. Collaborates with Services Areas, Regions & Health Ministries to ensure consistency & integration of strategy & operations while maintaining awareness of new industry developments & standards. Provides decision support, operations & / or optimization leadership focus. Essential Functions Our Trinity Health Culture: Knows, understands, incorporates & demonstrates our Trinity Health Mission, Values, Vision, Actions & Promise in behaviors, practices & decisions. Leadership: Providing advice, guidance & leadership to RHM & Region leaders in developing strategies & in the achievement of performance goals. Enable Collaboration across & within service area, RHM & Regions to ensure consistency & integration of strategy & operations Direction & Growth: Providing advice, guidance & leadership to service area, functional area, RHM & Regions. Leading standardization / systemness & optimization of policy, process, methodology, establishing a national community of practice. Oversee Vendor / Contract Labor Management including centralizing strategy & optimizing spend. Strategic Support & Accountability: Collaborates in system-wide strategy development & deployment of functional area priorities & initiatives. Responsible for supporting regional efforts to comply with functional area priorities. Accountable for the selection, evaluation & overall success of the functional leadership teams. Organization-wide focal point for establishing functional strategies & governance over financials & staffing. Accountable for communication between service area functional area, RHM & Region leaders. Operational Delivery Responsible for measuring & reporting KPIs / metrics &value delivery. Providing advice, guidance & leadership for the colleague life cycle. Maintains a Working Knowledge of applicable federal, state & local laws / regulations, Trinity Health Integrity & Compliance Program & Code of Conduct, as well as other policies, procedures & guidelines in order to ensure adherence in a manner that reflects honest, ethical & professional behavior & safe work practices. Functional Role (not inclusive of titles or advancement career progression) Provides leadership & strategic oversight of the Trinity Health Medical Group’s (THMG) Ambulatory Clinical Documentation Integrity program. Designs & builds structure, workflows & guidance of best practice documentation standards to ensure coding compliance & minimize audit liability. Provides emphasis on adherence to CMS & other insurance carrier standards, optimizing revenues & the avoidance of monetary settlements from third party audits. Works with providers & ambulatory practice leaders to develop accurate, effective, efficient & compliant documentation processes that ensure patient quality for all services provided & clinical documentation exists to support appropriate coding & billing. Stays current with organizational alternate payment models & contracting to help prioritize work assignment for ambulatory clinical documentation integrity specialists. Develops & sustains working relationships with providers, advanced practice providers & administrators to promote success of the Clinical Documentation Integrity program. Ensures educational materials & programs are available to staff & providers around complete & compliant documentation. Assists in the development of software applications in assigned areas while identifying & resolving trends with process gaps causing errors in documentation.

Requirements

Bachelor’s degree in Business Administration, Healthcare Administration, Nursing or related field, or equivalent combination of education & experience
Experience with compliant healthcare documentation, HCC coding requirements, alternate payment models in a multi-facility, integrated health care delivery system, revenue cycle or consulting experience, with progressive responsibility in management or leadership experiences in clinical documentation integrity, coding, healthcare quality or equivalent
Certified Risk Adjustment Coder (CRC), Certified Clinical Documentation Integrity (CDI), Certified Clinical Documentation Specialist – Outpatient (CCDS-O), Certified Documentation Expert Outpatient (CDEO), or Certified Documentation Integrity Practitioner (CDIP) credential with coding or clinical documentation integrity experience
Ambulatory or outpatient experience with Medicare, Medicaid & other third-party billing rules & regulations

Nice To Haves

Master’s degree in nursing, HIM or related healthcare field

Responsibilities

Accountable for leading, guiding & directing the functional responsibilities within an area of assignment.
Enable ministry-level or enterprise-wide functional strategy to address internal or external business & regulatory issues.
Provide functional expertise & ensure fulfillment of performance & service standards.
Responsible for consistent operating performance & achieving financial goals.
Identifies, defines & solves complex problems that impact the management & direction of the business.
Collaborates with Services Areas, Regions & Health Ministries to ensure consistency & integration of strategy & operations while maintaining awareness of new industry developments & standards.
Provides decision support, operations & / or optimization leadership focus.
Providing advice, guidance & leadership to RHM & Region leaders in developing strategies & in the achievement of performance goals.
Enable Collaboration across & within service area, RHM & Regions to ensure consistency & integration of strategy & operations
Providing advice, guidance & leadership to service area, functional area, RHM & Regions.
Leading standardization / systemness & optimization of policy, process, methodology, establishing a national community of practice.
Oversee Vendor / Contract Labor Management including centralizing strategy & optimizing spend.
Collaborates in system-wide strategy development & deployment of functional area priorities & initiatives.
Responsible for supporting regional efforts to comply with functional area priorities.
Accountable for the selection, evaluation & overall success of the functional leadership teams.
Organization-wide focal point for establishing functional strategies & governance over financials & staffing.
Accountable for communication between service area functional area, RHM & Region leaders.
Responsible for measuring & reporting KPIs / metrics &value delivery.
Providing advice, guidance & leadership for the colleague life cycle.
Maintains a Working Knowledge of applicable federal, state & local laws / regulations, Trinity Health Integrity & Compliance Program & Code of Conduct, as well as other policies, procedures & guidelines in order to ensure adherence in a manner that reflects honest, ethical & professional behavior & safe work practices.
Provides leadership & strategic oversight of the Trinity Health Medical Group’s (THMG) Ambulatory Clinical Documentation Integrity program.
Designs & builds structure, workflows & guidance of best practice documentation standards to ensure coding compliance & minimize audit liability.
Provides emphasis on adherence to CMS & other insurance carrier standards, optimizing revenues & the avoidance of monetary settlements from third party audits.
Works with providers & ambulatory practice leaders to develop accurate, effective, efficient & compliant documentation processes that ensure patient quality for all services provided & clinical documentation exists to support appropriate coding & billing.
Stays current with organizational alternate payment models & contracting to help prioritize work assignment for ambulatory clinical documentation integrity specialists. Develops & sustains working relationships with providers, advanced practice providers & administrators to promote success of the Clinical Documentation Integrity program.
Ensures educational materials & programs are available to staff & providers around complete & compliant documentation.
Assists in the development of software applications in assigned areas while identifying & resolving trends with process gaps causing errors in documentation.