Director - System Clinical Documentation Integrity

Approximate Salary Ranges:
RN Licensed: $126,500 to $179,000/year
Non-RN Licensed: $110,000 to $152,000/year

Remote eligible in the following states. Please do not submit your application unless you current have permanent residence in one of the following states: Arkansas, Arizona, Florida, Idaho, Missouri, Montana, Nevada, New Mexico, North Carolina, Oklahoma, Oregon, Tennessee, Utah, Wisconsin

ST. CHARLES HEALTH SYSTEM

JOB DESCRIPTION

TITLE:                                     Director, System Clinical Documentation Integrity

REPORTS TO POSITION:     Senior Director – System Revenue Integrity

DEPARTMENT:                       Revenue Integrity

DATE LAST REVIEWED:        August 2024

OUR VISION:                           Creating America’s healthiest community, together

OUR MISSION:                        In the spirit of love and compassion, better health, better care, better value

OUR VALUES:                         Accountability, Caring and Teamwork

DEPARTMENT SUMMARY: The Revenue Integrity (RI) department focuses on charge capture optimization and documentation improvement through collaboration and education. The Revenue Integrity department provides many services to our multi-hospital and medical group organization focusing on the patient financial experience along the entire continuum of care. Our goal is to deliver delightful, transparent, and seamless experience to our patients and customers that captures and collects the revenue earned by St. Charles Health System (SCHS) in a quality, efficient and timely manner.

POSITION OVERVIEW: This position will be responsible for overseeing and managing the daily operations of all Clinical Documentation Integrity activities and scope of responsibilities across the health system. This position requires advanced knowledge of coding guidelines, payment methodologies, and Clinical Documentation Integrity concepts for hospital/facility and professional/ambulatory services. Strong analytical and technical skills are needed as well as the ability to relay complex information to different levels of audiences.

This position directly manages caregivers in Revenue Integrity for Inpatient Facility Clinical Documentation Integrity, Outpatient Facility Clinical Documentation Integrity, and Ambulatory/Professional Clinical Documentation Integrity.

ESSENTIAL FUNCTIONS AND DUTIES:

Responsible and accountable for the successful daily operations of the Clinical Documentation Integrity and other assigned teams, as well as the overall performance of the program.

Develop and provide ongoing education for staff as needed. This includes identifying gaps and appropriate resources to facilitate continuing education.

Provide expert support and/or develop team resources needed to provide details for appeals/denials topics related to Clinical Documentation Integrity functions such as DRG downgrades, charges for clinical services, or in assistance of coding.

Maintain, develop, and implement policies and procedures for the organization to provide an effective and well-coordinated Clinical Documentation Integrity program and maintain compliance with regulatory bodies/agencies such as CMS, Joint Commission, etc.

Lead efforts to facilitate optimization of electronic tools, processes and resources for use by Clinical Documentation Integrity teams.

Develop annual workplan for System Clinical Documentation Integrity Program that is aligned with organizational and departmental goals. The plan should support financial growth, sustainability and stewardship through targeted improvement and opportunity.

Responsible for providing information to support Revenue Integrity department budget development, regular monitoring, accountability and meeting all operational targets for all areas within span of control.

Hires, directs, coaches and monitors the performance of all direct reports, to develop and maintain a high-performance team that meets organizational and department goals.

Monitors and ensures all direct reports are current with compliance and safety requirements. Implements and manages all organizational safety directives and goals.

Provides and oversees team’s delivery of customer service in a manner that promotes goodwill, is timely, efficient, and accurate.

Collaborates with teams to review processes and identify/implement opportunities for improvements, applying Lean principles, concepts and tools.

Creates a healing environment that supports all aspects of care, respects the wholeness of the individual, and demonstrates therapeutic presence through attitudes and behaviors that enhance the care experience for patients and caregivers.  

Facilitate the growth and development of a culturally competent team in the provision of appropriate care to patients and family members who belong to diverse cultural backgrounds.

Supports the vision, mission, and values of the organization in all respects.

Supports the Lean principles of continuous improvement with energy and enthusiasm, functioning as a champion of change.

Provides and maintains a safe environment for caregivers, patients, and guests.

Conducts all activities with the highest standards of professionalism and confidentiality. Complies with all applicable laws, regulations, policies, and procedures, supporting the organization’s corporate integrity efforts by acting in an ethical and appropriate manner, reporting known or suspected violation of applicable rules, and cooperating fully with all organizational investigations and proceedings.

May perform additional duties of similar complexity within the organization, as required or assigned.                    

EDUCATION:                  

Required: Bachelor’s degree in healthcare or related field.         

Preferred: Bachelor of Science in Nursing.       

LICENSURE/CERTIFICATION/REGISTRATION:

Required: Current Oregon RN license, Certified Clinical Documentation Specialist (CCDS) or Registered Health Information Administrator (RHIA).

EXPERIENCE:

Required: Seven (7) years coding experience with IP Facility focus OR minimum five-seven (5-7) years of Clinical Documentation Integrity specialist experience, Minimum two (2) years leadership experience.

Preferred: Three (3) years acute clinical care experience; Five (5) years leadership experience of Clinical Documentation Integrity department that includes OP Facility and Professional Services.

PERSONAL PROTECTIVE EQUIPMENT:

Must be able to wear appropriate Personal Protective Equipment (PPE) required to perform the job safely.

ADDITIONAL POSITION INFORMATION:

Travel: Ability to travel to business functions/trainings/meetings and all SCHS worksites. 

Schedule Weekly Hours:

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