Manager, Clinical Documentation Improvement

Job Title: Clinical Documentation Improvement Manager

Job Type: Hybrid - up to 25% travel

RN LICENSED; SUPERVISOR STATUS

PRIMARY PURPOSE: Primary Purpose of the Job

The Clinical Documentation Improvement (CDI) Manager coordinates the prioritization and oversees the day-to-ay workflow of the CDI staff and provides clinical documentation improvement expertise. This position is an experienced CDI Specialist who reports to the CDI Manager to ensure high quality and production standards are met. This will be accomplished through data evaluation, direct observation and review of medical records, and daily staff communication. The CDI Manager is responsible for maintaining prospective and retrospective review expertise to ensure accuracy, specificity, and severity captures are obtained consistently by all reviewers. The CDI Manager is expected to supervise the education and onboarding process of all new hires, perform duties and conduct interpersonal relationships in a manner that promotes a team approach and collaborative work environment with providers, CDI staff, and coders.

ESSENTIAL FUNCTIONS:

Qualified individuals must have the ability to perform the following:

• Oversee and supervise the daily workflow, quality, and production standards of CDI team.
• Provide oversight as the key resource on documentation and coding.
• Ensure monthly production and key metrics are met through data evaluation, direct observation, and review of medical records. Provide coaching as needed.
• Maintain expertise in prospective and retrospective reviews to ensure accuracy, specificity, and severity captures are obtained consistently by all reviewers.
• Participate in the education and onboarding of new CDI hires, including travel for in-person training. Develop and implement clinical documentation education programs for CDI specialists and providers.
• Analyze data to identify areas needing stronger education for providers and staff. Conduct individual and group educational sessions.
• Collaborate with the CDI Manager and other clinicians to update orientation content, educational materials, and training resources. Assist in developing and editing policies and procedures.
• Work with CDI Manager to resolve documentation discrepancies and clinical disparities.
• Maintain current knowledge of trends, regulations, and technology related to documentation, coding, reimbursement, and regulatory guidelines.
• Assist the CDI Manager in preparing data and reports to evaluate the effectiveness of the CDI program. Present findings to stakeholders.
• Engage in organizational initiatives and performance improvement projects.
• Lead and attend team meetings.
• Perform other duties as assigned.

MINIMUM QUALIFICATIONS:

• Master's degree in nursing, OR equivalent degree in Health Information Management or related field with CDI experience preferred.
• 2 years of experience as a CDI Specialist required.
• 2 years of ICD-10-CM coding experience required.
• CCDS, CDIP or CCS desired or ability obtain within 6 months of employment in the role.

KNOWLEDGE, SKILLS, & ABILITIES:

• Advanced clinical expertise and extensive knowledge of complex disease processes with a broad clinical experience in a clinical setting required.
• A broad knowledge of the disease process, normal/abnormal findings, and reasonable course of treatment, quality measures, and risk management issues is essential.
• Demonstrated competency in teaching/learning process, organizational skills and computer literacy required.
• Excellent communication skills and professional demeanor is required.

PREFERRED QUALIFICATIONS:

• Previous educator or supervisory experience with a strong understanding of the requirements for clinical coding and documentation according to the rules of Medicare, Medicaid, and commercial payers preferred.
• Electronic medical record and chart review experience preferred.
• CDIP, CCDS, CCS, or equivalent desired.