Manager Clinical Documentation Integrity RN

MyMichigan Health • Midland, MI

4d

About The Position

The Manager of Clinical Documentation Integrity provides strategic leadership, daily operational direction, and continuous evaluation for the Inpatient and Ambulatory Clinical Documentation programs across the healthcare system. The role connects acute-care outcomes—including MS-DRG/APR-DRG assignment, Severity of Illness, and Risk of Mortality—with ambulatory risk adjustment through Hierarchical Condition Categories (HCCs), supporting appropriate risk adjustment, reimbursement, and clinical quality tracking. The Manager supervises a split or cross-functional team of CDI Specialists and HCC coders, leading system-wide provider education, data analytics, and compliant workflows.

Candidates must have a primary address in Michigan or be willing to move to Michigan. Employees are expected to understand and support MidMichigan Health’s vision and mission and demonstrate its values of excellence, integrity, teamwork, and accountability.

Requirements

• Bachelor's degree required.
• Registered Nurse (RN) certification/licensure.
• NIMS IS 100, NIMS IS 700, and NIMS IS 200 certifications must be completed within six months of hire or transfer.
• Certified Clinical Documentation Specialist (CCDS); the Certification of Clinical Documentation Specialists Outpatient (CCDS-O) is accepted in lieu of CCDS.
• One to three years of CDI leadership experience.
• At least five years of current hospital clinical documentation improvement program experience.
• Thorough knowledge of CMS regulations, including coding guidelines, DRG reimbursement, and risk adjustment, including HCC/RAF coding and documentation requirements.
• Knowledge of state and federal Hospital Acquired Conditions (HAC) and other applicable quality indicator codes, including PSI and PPI.
• Written and verbal communication skills to interact successfully with individuals and groups at all organizational levels.
• Expertise with inpatient and ambulatory CDI software applications.
• Annual tuberculosis testing and annual OSHA training according to the Exposure Control Plan.
• Competency in Microsoft Windows and willingness to participate in further learning opportunities offered by MyMichigan Health.
• Ability to handle multiple tasks, work independently, get along with others, maintain regular and predictable attendance, and stay awake.
• Ability to move about the facility with or without an assistive device and perform the job functions described.
• Overall vision and hearing, with or without assistive devices, and dexterity for handling, reaching, grasping, fingering, and feeling.
• Ability to tolerate stressful situations and wear personal protective equipment, including latex materials or an appropriate substitute if required.
• Ability to sit, stand, or walk for long periods and occasionally lift or carry 11–20 pounds; frequently handle 10 pounds and/or walk, stand, or push/pull arm or leg controls.

Nice To Haves

• Master's degree preferred.

Responsibilities

• Maintain knowledge of MS-DRGs, CCs/MCCs, quality impacts, risk of mortality, severity of illness, CMI, ICD-10 coding systems, and CDI coding and documentation guidelines.
• Formulate, standardize, and enforce compliant query practices aligned with AHMIA and ACDIS coding and documentation standards.
• Understand risk-adjusted payment methodologies, HCC assignment and payment methodology, professional and outpatient facility coding and billing, and OPPS reimbursement methodology; share this expertise to support collaboration and revenue integrity.
• Promote collaborative, high-functioning teams through clear communication, shared success metrics, and staff mentoring.
• Communicate with and educate providers and healthcare team members about clinical documentation, and monitor provider participation.
• Ensure direct reports communicate, educate, and engage physicians and other healthcare team members regarding clinical documentation.
• Develop inpatient and ambulatory CDI programs, including department processes, policies, staff education, and provider education through presentations and individual instruction, including new-provider education.
• Analyze data to identify trends and improvement opportunities, including PEPPER reports, mortality, and readmissions.
• Oversee denials and appeals processes and use case information to drive provider education.
• Perform CDI reviews as needed to support the program during high-volume periods.
• Develop staff through precepting, audits, and focused individual or group education.
• Lead or actively participate in meetings and department performance-improvement and employee-engagement activities.
• Complete other duties or special projects requested by leadership and proactively communicate problems that could affect department operations.
• Model professional standards of behavior, remain engaged in departmental goals and vision, and encourage staff to do the same.

What This Job Offers

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