Clinical Documentation Improvement and Quality Manager

Job Detail

Job Title :

Clinical Documentation Improvement and Quality Manager

Department :

80100-Health Information Management

Location : Farmington

Farmington

FTE% : Shift

Shift

Search # : 2023-1394

2023-1394

Closing Date : Recruiter :

Recruiter : Rucker, Pamela S.

Rucker, Pamela S.

Additional Links :

CLINICAL DOCUMENTATION IMPROVEMENT & QUALITY MANAGER

PURPOSE OF CLASS :

At UConn Health,the Clinical Documentation Improvement an Quality Manager is responsible for planning, directing, coordinating, evaluating, and supervising the staff engaged in the quality of care reviews on all services, compliance with policies, regulatory guidelines,high quality and production standards accuracy, and resolution of coding discrepancies.

SUPERVISION RECEIVED : Works under the general supervision of an employee of higher grade.

SUPERVISION EXERCISED : Supervises Clinical Documentation Specialists and other staff as assigned.

COMPREHENSIVE BENEFITS OFFERED :

Industry-leading health insurance options and affordability

Generous vacation and sick-time plans

Multi-channel retirement options (pension and match options)

Tuition waiver and reimbursement for employees and qualified family members

Quick commute access from I-84, Rte 9 and surrounding areas

State of the art facility and campus environments

Progressive leadership and educational development programs available

Schedule : 40 hours per week, Monday - Friday, 8 : 00am - 4 : 30pm with a 30 minute unpaid meal break

EXAMPLES OF DUTIES :

• Plans and directs unit workflow and determines priorities; schedules, assigns, oversees and reviews the work of staff; provides staff training and assistance;
• conducts performance evaluations; establishes and maintains unit procedures;
• Acts as liaison with operating units, agencies and outside officials regarding unit policies and procedures. Develops, assists and makes recommendations with related policies or standards;

and prepares reports and correspondence as needed.

• Ensures monthly production and key metrics are met and provides coaching as needed;
• Collaborates with the CDI Physician Champion and Coding Manager to resolve DRG coding and documentation discrepancies, clinical disparities education and training needs for physicians, CDI and Coding staff;

Identifies opportunities for improvement by studying the variances form policies and practices. Prepares reports to leadership as opportunities for improvement.

Monitors documentation and coding of staff for compliance and regulatory standards; identifies variances from practice and policy and opportunities for improvement;

Participates in and contributes to organizational and departmental initiatives and performance improvement projects.

Keeps abreast of changing trends, regulations and technology related to documentation, coding, and reimbursements;

Collaborate with interdisciplinary teams including, but not limited to, denials management, Utilization management, Quality and Case Management.

Assists with strengthening technical coding practices and clinical documentation by reviewing patient records with flagged complications (, patient Safety Indicators (PSI) to ensure that coding accurately reflects the patient's clinical course and complexity for accurate risk adjustment used in government incentive / penalty programs

Performs related duties as required.

MINIMUM QUALIFICATIONS REQUIRED :

KNOWLEDGE, SKILL AND ABILITY :

• Considerable knowledge of applicable regulatory guidelines;
• Considerable knowledge of third party documentation standards and regulatory guidelines;
• Considerable knowledge of quality assurance and process improvement measures related to documentation;
• Knowledge of the nursing process and complex disease processes;
• Advanced clinical expertise in an acute care, inpatient setting;
• Knowledge of insurance company reimbursement principles, CPT, ICD CM / PCS, and DRG coding;
• Knowledge of coding and documentation procedures applicable to various specialties;
• Considerable interpersonal skills; oral and written communication skills;
• Proficient computer skills to include Microsoft office suite;
• Ability to analyze, develop and present high level analysis and metrics;

Supervisory ability.

EXPERIENCE AND TRAINING :

General Experience :

Bachelor's or Master's degree in Nursing, or equivalent degree in HIM field with CDI experience

Registered Nurse and either three (3) years of medical / surgical / critical care experience in an acute care or clinical practice or three (3) years utilization / clinical casemanagement experience in a hospital setting; and

SPECIAL REQUIREMENTS :

Must possess and maintain licensure as a Registered Nurse in the State of Connecticut;

Certification as a Certified Clinical Documentation Specialist (CCDS) through the Association of Clinical Documentation Integrity Specialists (ACDIS), or as a Certified Documentation Improvement Practitioner (CDIP) through the American Health Information Management Association (AHIMA).

If not certified at time of hire, must obtain certification within one (1) year of employment in the role.