Regional Manager Clinical Documentation Integrity ( Remote)

Trinity Health; United States; Remote; USD 52,000 - 85,000; Full time

Job summary

Trinity Health seeks a remote CDI Program Director to lead Clinical Documentation Integrity initiatives across Health Ministries. You will guide program standards, monitor dashboards, and drive improvements in documentation quality and coding accuracy.

You’ll train CDS teams, collaborate with medical leaders, and ensure regulatory and DRG integrity. Strong leadership and CDI expertise are essential for success.

Qualifications

• Bachelor’s degree inHealth Information Management or related field.
• Experience leading CDI programs and teams is preferred.
• Strong data analysis and education/training skills.

Responsibilities

• Directs CDI activities for Health Ministries region.
• Provides training to clinical documentation specialists.
• Monitors CDI dashboards and performance reports.
• Develops action plans to improve program metrics.
• Educates physicians and staff on documentation best practices.

Skills

Clinical Documentation

Leadership

Training

Data analysis

Project management

Education

Bachelor's degree in Health Information Management

Tools

3M CDI software

3M/360

Job description

Employment Type: Full time

Shift: Day Shift

POSITION PURPOSE

Work Remote Position

Responsible for directing Clinical Documentation Integrity (CDI) activities for the Health Ministries (HM) in their defined region and day-to-day management of the CDI programs. Works with Director, CDI to ensure the program is in alignment with the Trinity Health CDI Program standards, polices, procedures, workflows. Uses available tools and reports to monitor CDS productivity, accuracy and compliance and will be responsible for addressing and refining processes to improve performance and achieve defined goals. Provides training and education to clinical documentation specialists (CDS) to enhance clinical and coding skill sets and optimal utilization of 3M CDI software.

Analyzes data to determine educational opportunities and will create and provide training to documenting providers to improve documentation quality.

Works closely with Regional and Local Health Physician Champions, Chief Medical Officers, HM Executive Leadership, clinical staff, coding and denials teams to facilitate documentation within the medical record and supports the patient's severity of illness, risk of mortality, clinical validity and proper DRG assignment.

ESSENTIAL FUNCTIONS

1. Knows, understands, incorporates and demonstrates the Trinity Health Mission, Vision and Values in leadership behaviors, practices and decisions.

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2. Ensures HM CDI Team compliance with Trinity Health CDI Program standards, polices, procedures, workflows, and CDI software standard use and adoption.

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3. Monitors system CDI Dashboard and HM CDI Monitoring Reports to identify opportunities for improvement and areas of focus for the HM CDI programs.
4. Develops and implements action plans for program performance under target benchmarks.

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5. Understands and communicates appropriate clinical documentation and clinical validation to ensure that the severity of illness, risk of mortality and level of services provided are accurately reflected in the health record. Assists in overall quality, timeliness and completeness of the quality health record to ensure appropriate data, provider communication and quality outcomes. Serves as a resource for appropriate clinical documentation.

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6. Develops CDS team through hiring, maintaining work schedules, balancing workload and conducting performance evaluations. Mentors and coaches colleagues to ensure positive outcomes.

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7. Demonstrates a thorough understanding of the MS-DRG system, CCs/MCCs, impact on quality and CMI as well as ICD-10 coding systems and the guidelines related to Clinical Documentation Improvement. Serves as a resource for the CDS team for any of the above.

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8. Ensures that direct reports remain current in coding guidelines and other regulatory directives that impact CDI performance. Ensures all compliance and regulatory standards are met.

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9. Ensures that direct reports perform clinical validation as part of the review process and remain current on CDI strategies.

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10. Uses 3M/360 for entering and abstracting data related to CDI performance. Monitors the CDI Dashboard and reporting to identify opportunities for improvement and areas of focus.

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11. Communicates with and educates physicians and all other members of the healthcare team regarding clinical documentation, and monitors provider participation. Identifies learning opportunities for healthcare providers.

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12. Ensures that direct reports communicate, educate and engage with physicians and other members of the healthcare team regarding clinical documentation.

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13. Collaborates with coding leaders to assure documentation of diagnoses and co-morbidities are a complete reflection of the patient's clinical status and care. Resolves all discrepancies in a courteous manner.

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14. Demonstrates expertise in problem-solving skills based on theoretical knowledge, clinical experience and sound judgment and serves as a professional role model by demonstrating desirable practice behaviors.

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15. Maintains a working knowledge of applicable Federal, State, and local laws and regulations, Trinity Health Corporate Integrity Program, Code of Ethics, as well as other policies and procedures in order to ensure adherence in a manner that reflects honest, ethical, and professional behavior.

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(Salary Range: $51.8114-$85.4888)

MINIMUM QUALIFICATIONS

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1. Bachelor's degree in Health Information Management, Healthcare related field or Nursing or the equivalent in experience.
2. Must possess one of the below:
   • Current Registered Nurse (RN) License
   • Registered Health Information Administrator (RHIA)
   • Registered Health Information Technician (RHIT)
   • Certified Coding Specialists (CCS)
   • Licensure as a physician assistant (PA) or Nurse Practitioner/Advanced Practice Nurse (NP/APN) or completion of medical school
   • Certified Clinical Documentation Specialists