Director of Clinical Documentation Improvement and SLR

Main Line Health; Newtown Square (Delaware County); Sur place; USD 170 000 - 205 000; Plein temps

Avantages offerts par ce poste

Flexible PTO program

Employee discounts

Employee parking free

Résumé du poste

Main Line Health in Newtown Square seeks a Director of Clinical Documentation Improvement and Second Level Review to lead system-wide CDI and SLR programs. You will oversee literacy in documentation accuracy, drive physician engagement, and ensure coding aligns with clinical risk and reimbursement needs.

Responsibilities include strategic leadership, program oversight, and collaboration with Revenue Cycle, Compliance, and executive leadership.

Qualifications

• Minimum seven to ten years of progressive leadership experience in Clinical Documentation Improvement, Health Information Management, Coding, Revenue Cycle, or Clinical Quality.
• Experience leading multi-site CDI programs.
• Strong knowledge of ICD-10-CM/PCS coding, MS-DRGs, APR-DRGs, quality reporting methodologies, risk adjustment, reimbursement systems, and regulatory compliance requirements.
• Experience presenting to executive leadership, physicians, and governing committees.

Responsabilités

• Strategic Leadership and Program Oversight for CDI and SLR.
• Oversees CDI and SLR strategy, goals, standards, and system-wide initiatives.
• Directs documentation integrity, quality reporting, reimbursement, and compliance.
• Oversees concurrent and retrospective CDI reviews to reflect acuity and medical necessity.
• Leads post-discharge SLR processes for accurate code assignment and DRG validation.
• Establishes review methodologies for high-risk DRGs and diagnoses.
• Ensures compliance with federal, state, payer, and accreditation requirements.
• Directs audits, external responses, corrective actions, and risk mitigation.
• Oversees physician and provider documentation education strategies.
• Supports coaching, mentoring, and succession planning.
• Collaborates with Revenue Cycle, Quality, Medical Staff, Compliance, and executives.

Connaissances

CDI leadership

Regulatory compliance

Executive communication

Multi-site leadership

Physician engagement

Formation

Bachelor's degree

Master's degree (preferred)

Description du poste

Could you be our next Director of Clinical Documentation Improvement and Second Level Review?

Why work as a Director of Clinical Documentation Improvement and Second Level Review with Main Line Health?

Make an Impact!

Responsibilities

The Director of Clinical Documentation Improvement (CDI) and Second Level Review (SLR) provides system-wide leadership for clinical documentation integrity and post-discharge review operations. This role ensures clinical documentation accurately supports quality outcomes, SOI/ROM, patient safety indicators, reimbursement integrity, and regulatory compliance. Responsibilities include:

• Strategic Leadership and Program Oversight
• Leads CDI and SLR strategy, goals, standards, and system-wide initiatives.
• Serves as a subject matter expert for documentation integrity, quality reporting, reimbursement, and compliance
• Clinical Documentation Improvement Oversight
• Oversees concurrent and retrospective CDI reviews to ensure documentation reflects acuity, SOI/ROM, medical necessity, and resource utilization.
• Leads improvement efforts focused on documentation accuracy, physician engagement, query compliance, and outcomes.
• Second Level Review Oversight
• Leads post-discharge SLR processes for accurate code assignment, DRG validation, SOI/ROM assignment, and quality data integrity.
• Establishes focused review methodologies for high-risk, high-volume, and high-impact DRGs and diagnoses.
• Quality, Regulatory, and Compliance Management
• Ensures compliance with federal, state, payer, and accreditation requirements related to documentation and coding.
• Directs audits, external review responses, corrective action plans, and compliance risk mitigation strategies.
• Physician Engagement and Education
• Oversees physician and provider documentation education strategies.
• Leadership and Talent Development
• Supports coaching, mentoring, succession planning, and a culture of accountability and collaboration
• Collaboration and Organizational Partnerships
• Collaborates with Revenue Cycle, Quality, Medical Staff, Compliance, Case Management, Utilization Review, Finance, Information Systems, and executive leaders.

Develop and Grow Your Career!

Invest in furthering your education through seeking certifications or advanced degrees by taking advantage of our Tuition Reimbursement! This position is eligible for up to $6,000 per year based upon your Full or Part Time status.

Join the Team!

Like our patients, the Main Line Health Family encompasses a wide range of backgrounds and abilities. Just as each of our patients requires a personalized care plan, each of our employees, physicians, and volunteers, bring distinctive talents to Main Line Health. Regardless of our unique design, we all share a purpose: providing superior service and care.

Position-Specific Benefits Include

• Main Line Health's Flexible PTO program
• Employee discounts to various activities, services, and vendors
• Employee parking is always free

Position

Director, HIM Revenue Cycle

Shift

M-F Days

Experience

• Minimum seven to ten years of progressive leadership experience in Clinical Documentation Improvement, Health Information Management, Coding, Revenue Cycle, or Clinical Quality
• Demonstrated experience leading multi-site CDI programs
• Strong knowledge of ICD-10-CM/PCS coding, MS-DRGs, APR-DRGs, quality reporting methodologies, risk adjustment, reimbursement systems, and regulatory compliance requirements
• Experience presenting to executive leadership, physicians, and governing committees

Education

• Bachelor's degree required.
• Master's degree in Health Administration, Business Administration, Nursing, Health Informatics, or related field preferred.

Licensures/Certifications

• RHIA, RHIT, CCDS, CDIP, RN, or equivalent certification required
• CCS coding certification preferred