Director of Clinical Documentation Improvement
This position is with a national specialty physician group and is responsible for overseeing clinical documentation improvement projects, identifying and focusing on areas of improvement through analysis and interpretation of operational, financial, compliance & quality rating reports. Your team will serve as the subject matter expert on HCC weightings and annual adjustments. Your team will work with clinical leaders to determine opportunities in proactive population screenings for risk cohorts in order to properly detect and enable management of high-risk co-morbidities. You will manage various operational matters, to include the appropriate scheduling and coverage of reviews, automated query development and auditing processes in collaboration with analytics team, educating providers, monitoring the program, and refining processes to clarify record documentation. You will serve as a resource to providers and administration regarding issues related to the appropriateness of screening protocols and coding. Additionally, you will work collaboratively with the providers and coding staff to facilitate documentation within the medical record that supports a patient's medical decision making and risk adjustment for mortality utilizing strong communication skills with providers, nurses or other healthcare professionals.
- Plan and manage single or large project and is responsible (individually or through others) for target performance improvements.
- Initiate and maintain C suite - level member relationships to disseminate messaging around tracking and monitor performance milestones.
- Craft and deliver communications with clarity and confidence to SVP.
- Contribute to practice development by developing intellectual property (IP).
- Supervise, mentor and coach others on the team while reporting into the SVP of Health Economics.
- Relevant degree is desired, preferably in business, healthcare administration or a related field. Master’s degree or above preferred.
- 5 or more years of relevant experience working within healthcare preferred.
- Extensive knowledge of CMS risk stratification methodologies.
- Experience in either Health Information Management, Case Management, Clinical Quality and Patient Safety, Regulatory and Compliance, Healthcare Analytics and other areas of clinical operations and clinical administration desired.
- Strategic thinking on building a comprehensive program to enable better population management within risk agreement models.
- Clinical Documentation Improvement Practitioner (CDIP) is highly desirable.
- Previous leadership and supervisory experience preferred.
- Ability to effectively understand and present information to executive leadership.
- Ability to display/use tact and good judgment in communicating project activities to both staff and clients.
- Able to effectively facilitate meetings, present information to top management and respond to questions.
- Solid ability to analyze, interpret and present data in meaningful ways.
- Demonstrated ability to lead in a cross-functional, complex team environment that requires quick turnaround and quality output.
- Ability to travel regularly and expeditiously throughout the year to meet partners’ needs and timetables.