Manager - Clinical Doc Improvement - ROC - FT

UHS•Edinburg, TX

12d•Hybrid

About The Position

The Texas CDI Market Manager manages the Physician & Clinical Documentation Integrity (PDI/CDI) team for the Texas Market (STHS, DHL, FDRMC, NWT, TMC). Responsible for managing the day-to-day operations of PDI/CDI including staffing, scheduling, performance reviews and employee performance management. Attends and participates in hospital meetings and performance improvement initiatives to support the hospitals within the Texas Market. Oversee the compliance auditor, the clinical review process for concurrent and retrospective reviews of inpatient medical records, evaluating the utilization and documentation of acute care services. Works in collaboration with the Texas Market CDI Director to provide on-going physician education and CDI staff development. The goal of concurrent review includes facilitation of appropriate physician/provider documentation of care delivered to accurately reflect patients’ intensity of care, Severity of Illness (SOI) and Risk of Mortality (ROM). Focus of specific reviews are both determined internally and external by requirements/requests of payers or regulatory agencies and play a significant role in reporting quality of care outcomes and in obtaining accurate and compliant reimbursement for acute care services. Will serve as a backup to Market CDI director in his/her absence. This position will also provide monthly reports collaborating with Texas Market facility CFO’s, collaborate with the Market Coding Director and all Texas Market facility HIM Directors to meet the goals and objectives of the facilities. Responsible and accountable for providing exceptional customer service.

Requirements

Minimum of 5 years recent clinical/medical experience in an acute care setting or patient care setting required.
Minimum of 5 years acute care inpatient CDI experience required
Excellent written and verbal communication skills required.
Excellent critical thinking skills required and must be detail oriented.
Knowledge of age-specific needs and elements of disease process and related procedures required.
Strong broad based clinical knowledge and understanding of pathology/physiology of disease processes.
Ability to work independently in a time-oriented environment is essential.
Computer literacy essential.
Must demonstrate commitment and adherence to STHS’s Compliance Program and Code of Conduct through compliance with all policies and procedures, the Code of Conduct, attendance at required training and immediately reporting suspected compliance issue(s) to the Compliance Officer.

Nice To Haves

Working knowledge of Medicare reimbursement system and coding structures preferred, by not required.
Must be able to travel between facilities within the South Texas/Central Region as needed.
Current license as an RN/BSN if applicable.
Current credential as a Certified Clinical Documentation Specialist (CCDS) or Certified Documentation Improvement Practitioner (CDIP) if applicable

Responsibilities

Manage the Physician & Clinical Documentation Integrity (PDI/CDI) team for the Texas Market.
Manage the day-to-day operations of PDI/CDI including staffing, scheduling, performance reviews and employee performance management.
Attend and participate in hospital meetings and performance improvement initiatives.
Oversee the compliance auditor and the clinical review process for concurrent and retrospective reviews of inpatient medical records.
Evaluate the utilization and documentation of acute care services.
Provide on-going physician education and CDI staff development in collaboration with the Texas Market CDI Director.
Facilitate appropriate physician/provider documentation of care delivered to accurately reflect patients’ intensity of care, Severity of Illness (SOI) and Risk of Mortality (ROM).
Serve as a backup to Market CDI director in his/her absence.
Provide monthly reports collaborating with Texas Market facility CFO’s.
Collaborate with the Market Coding Director and all Texas Market facility HIM Directors to meet the goals and objectives of the facilities.
Provide exceptional customer service.