The Director of Clinical Documentation Integrity is responsible for planning and managing ICD-10 remediation and compliance efforts for clinical functions along with providing leadership and supervision of the Clinical Documentation Improvement (CDI) programs across the St. Joseph Health System. Primary duties include the development, improvement, maintenance, and implementation of clinical policies, processes, and workflows across inpatient and ambulatory settings that support clinician documentation across the continuum of care that drives compliance with ICD-9 and ICD-10 coding requirements. As a member of the cross-functional enterprise team, this position ensures that the clinical interdependencies with other key functions (e.g., quality, revenue cycle, finance, IT, CIS) are understood, aligned and managed. This position also serves as a liaison for local SJHS-facility leaders and physicians in managing and resolving program-related issues and best practice, standardized documentation processes.
Prepare and represent the interest of providers and clinicians across the SJH ministries for strategic transitions, through engagement and education strategies to create awareness and identifying solutions and developing key processes, policies and procedures for new initiatives.
Develop and implement steering committees dedicated to improving provider documentation. Communicate plans, best practice, and develop documentation requirements based on targeted audiences for each individual project. Provide guidance on developing physician education and structure for accountability and establish best practice sites providing a physician support structure.
Collaborating with interdisciplinary teams including, but not limited to, physicians, nurse practitioners, PA’s, Revenue Cycle, Coding and HIM, Quality, Case Management, Clinical Informatics System (CIS), to ensure the success of the Clinical Documentation Improvement (CDI) programs and improving provider documentation across the care continuum.
Accountable for the success of all CDI programs and works to develop, improve, grow, and refine the system-wide CDI model for all SJH ministries. Provide day-to-day oversight of the programs and serve as a resource for all CDI leadership throughout the system.
Monitor efficiency and productivity of all CDI programs to ensure compliance to national metrics and departmental performance standards. Formulating action plans as necessary to resolve knowledge gaps with employees or to address the implementation of new service offerings or code changes.
Utilizing a standard methodology, coordinates, compiles, trends, and shares data reflecting the activity associated with the CDI programs on an ongoing basis and aggregate comparison reflecting system-wide data and report key performance metrics for specific opportunities for improvement in CDI at the ministry, region, and system-wide level, in addition to creating and enforcing standard system-wide policies and procedures for the overall improvement of the CDI program across all SJH ministries.
Coordinating and leading monthly CDI Leadership meetings and function as committee leader and establish guidance and leadership for the CDI programs. Attends and participates in the Steering Committees focused on documentation improvement at each ministry.
Identify and mitigate risks throughout the ministries and provide ongoing feedback to the CDI teams, physician advisors, and executive leadership utilizing quarterly toolkits for continued program success.
Conducts education sessions with ministry CDI specialists and other health care team members on clinical documentation requirements for physician and clinicians.
Work closely with System-wide Director of HIM to plan, direct, and coordinate all activities necessary for the success and transition of CDI and HIM.
Executes problem identification, data gathering, and implementation of strategic actions that are in the best interest of the ministry, the SJH mission, vision, and values.
Work with providers to develop standardized templates across all SJH ministries and improving the query process in the electronic workspace, for overall advancement of the CDI query process and workflow.
Prepare for strategic initiatives, such as ICD-10 implementation, by accurately identifying and developing processes to obtain clinical documentation for key areas where specificity is needed in the current practice.
Establish processes and create effective project management tools to help guide project efforts and achieve desired project outcomes. Plan, direct, and coordinate activities of designated projects to ensure that goals or objectives of projects are accomplished within prescribed time frame and funding parameters.
Participate in ongoing regional/local ministry activities and System Office activities which enhance both internal and inter-departmental relationships.
Provide direct project management for regulatory and compliance related initiatives. Lead project team in developing, monitoring, and managing work plans.
Participate in vendor selections / vendor relationship management for enterprise projects representing the SJHS RCO team to ensure appropriate involvement and oversight.
Prepare enterprise level reports and/or dashboards for assigned ICD-10 projects. Work with ministry leaders, project managers, and project sponsors to ensure reports, dashboard information, and project documentation are accurate and up-to-date, particularly in terms of how the project(s) impact the ministries. Interface, when appropriate, with all areas affected by the project/initiative to include internal subject matter experts, external departments, and ministries.
Knowledge / Skills / Abilities:
Advanced understanding of clinical workflows, documentation, and electronic order entry management across inpatient and ambulatory settings.
Broad understanding of healthcare application technologies and the business departments and clinical functions that they enable, including the integration points between different application functions (e.g., CIS and scheduling/admission applications).
Ability to define and develop an effective project approach for a variety of projects, including projects with a high degree of complexity.
Strong planning and execution around business readiness including process re-engineering, training, and post implementation support for large, complex projects.
Exceptional project management and organizational skills, with the demonstrated ability to drive multiple concurrent projects to completion in a complex, consensus-oriented environment.
Advanced knowledge of project management practices and methodologies.
Knowledge of DRG, ICD-9 and CPT coding relative to physician clinical documentation.
Advanced clinical expertise and knowledge of disease processes with a broad clinical experience in an inpatient/outpatient setting.
Knowledge of concurrent review/clinical documentation improvement process
Knowledge of and experience with ICD-9-CM and competence in ICD-10 changes.
Knowledge of process improvement methodologies (i.e., Lean, Six Sigma).
Self-directed and motivated with strong analytical skills, systematic and orderly planning abilities, and high attention to details.
Strong written and oral communication skills and ability to deal assertively and strategically with physicians and nursing staff.
Ability to create and conduct presentations effectively and present to clinicians and ministry leadership.
Ability to work effectively and interact with all levels of management including executive leadership.
Ability to establish and manage complex and effective relationships.
Customer-focused attitude and ability to work proactively and efficiently with appropriate urgency.
Supportive of all decisions, choices, goals and objectives as determined by Revenue Cycle leadership, IT Executive leadership and overall SJHS leadership.
Ability to function in a matrix environment with SJHS clinical leadership
Flexibility to travel (up to 25% of the time)
Minimum Position Qualifications:
Bachelor’s degree in a related field.
6-10 years of healthcare experience in management or supervisory role and/or 6-10 years of progressive project/program management experience, with a strong background in clinical operations, performance improvement, and business analysis, including a proven ability to work collaboratively in group settings with various stakeholders, including executive leadership and clinicians, and experienced with the full system development lifecycle.
Preferred Position Qualifications:
Master’s degree in Business Administration, Health Administration, Health Services, or related area of study.
Clinical experience as a care provider. Proven ability to manage complex work streams across a multi-hospital integrated delivery network health system. Knowledgebase of current technological trends and developments in the information systems industry, specifically in healthcare. Experience with MEDITECH and Allscripts Enterprise EHR.
Current credential as a Registered Health Information Administrator (RHIA), or a Registered Health Information Technician (RHIT), or a Certified Coding Specialists (CCS) from AHIMA or Certified Professional Coder (CPC) from AAPC or current Registered RN or Certified Documentation Improvement Practitioner (CDIP) or Certified Clinical Documentation Specialists (CCDS).
Current California RN license.
St. Joseph Health (SJH) is an integrated healthcare delivery system sponsored by the St. Joseph Health Ministry and organized into three regions: Northern California, Southern California, West Texas/Eastern New Mexico.
SJH provides a full range of care from facilities including 14 acute care hospitals, home health agencies, hospice care, outpatient services, skilled nursing facilities, community clinics, and physician organizations. SJH maintains a 'continuum of care,' matched to the diverse needs of the urban centers, smaller cities and rural communities in three states. For the third year in a row in 2009, the Gallup Organization awarded St. Joseph Health its highest honor - the Great Workplace Award. SJH provides exceptional benefits, opportunities for advancement and relocation within the system.
St. Joseph Health is comprised of four core values: Service, Excellence, Dignity, and Justice are the guiding principles of all we do.
Excellent compensation program and benefits provided. SJH is an EEO/AA Employer.
Revenue Cycle Optimization
UBB System Office
500 S. Main Street, Suite 400
Yes, 25 % of the Time
St. Joseph Health
- 2 years ago - save job
St. Joseph Health (SJH) is an integrated healthcare delivery system sponsored by the St. Joseph Health Ministry and organized into three...