1+ months
2018-06-192018-08-18

Director - CDI

Mayo Clinic
Jacksonville, FL
City
Jacksonville
State
Florida
Telecommute
No
Department
Nursing
Position description
Coordinates all operations of allied health staff in the Clinical Documentation Integrity Department for the Local Site or Enterprise role in alignment with institutional and department/division mission, vision, and objectives. Serves as a key member of the CDI leadership team with a primary focus on planning and implementation of policies and systems. Facilitates large-scale project management to include: financial and quality analysis, problem solving, and team collaboration while leading a multidisciplinary team. Regulates staffing in accordance with fluctuating workload and shifting departmental priorities. Partners in the support of department/division and institutional projects, staff recruitment, policy implementation, and serves as a primary resource for issues and communications. Performs duties independently and initiates judgment in handling a variety of management issues in support of Enterprise initiatives.

The Director for Clinical Documentation Integrity leads the CDI program efforts for concurrent medical record review to promote the documentation required to support accurate and compliant coding. Participates in work groups to ensure medical record documentation supports medical necessity, appropriate length of stay, and supports accurate capture of physician and data quality. Supports processes resulting in a reduction of denials for medical necessity, appropriate assignment and reporting of Observed/Expected Mortality with an enhanced public perception via data quality reporting. The CDI-Director works within the framework of all areas of CDI to ensure documentation supports accurate coding as promulgated by the Cooperating Parties for the ICD-10-CM/PCS: the American Hospital Association (AHA), the American Health Information Management Association (AHIMA), CMS, and NCHS. Also, this role shall be knowledgeable and supportive regarding the Official Guidelines for Coding and Reporting, UHDDS definitions, and the Inpatient Prospective Payment System (IPPS) as defined by CMS. This role will lead collaborative partnerships with physician leaders (clinical advisors), nursing leaders, Case Management staff nurses and Directors and HIM Coding staff to assure appropriate clinical documentation.
The CDI- Director leads the team of Clinical Documentation Integrity Specialists for patients with DRG based payers and risk-adjusted metrics. This role ensures that reviews of the patient’s medical data are conducted along with ensuring the quality, completeness, and accuracy of medical record documentation. The CDI-Director ensures that the data reports are generated and analyzed for opportunities for improvement, participates as a leader of the documentation work group and makes recommendations based upon the data reports to drive improvement. Oversees the education of physicians and/or quality staff about CDI and collaborates with other disciplines regarding proposed DRG changes and quality concerns. Coordinates resources to implement new systems, programs and processes within the Clinical Documentation Integrity team.

The CDI-Director provides leadership with detailed project design documentation, project plans and process flows. Guides and supports projects, processes, implementation and training of teams. Conducts and/or facilitates complex business analysis for large process, quality and process improvement projects within Clinical Documentation Integrity and across Mayo Clinic's three group practices and Mayo Health System. Must demonstrate an understanding of operations, processes, systems, regulations, clinical practice and payers. The Director reviews and remains current on clinical documentation and coding issues that are occurring throughout the healthcare industry. Will coordinate and present the information relating to current issues as required to leadership and staff. Reviews and facilitates discussion when Clinical Documentation Integrity goals are different from inpatient billing requirements to ensure compliance. Coordinates teams of resources to ensure large project efforts are completed on time and within budget. CDI-Director is responsible to provide regular updates to leadership.

The CDI-Director participates in the design, development and implementation of new business process and system applications in collaboration with Systems Services and Information Technology staff. Effectively leads meetings, workgroups, and committees which include participants throughout Mayo Clinic. Specifies and facilitates resources for project completion. CDI-Director must demonstrate ability to make appropriate decisions regarding complex operational issues along with interacting collaboratively with various departments to support and direct activities and work flows. CDI-Director collaborates with leadership to resolve Enterprise Revenue Cycle issues and at times, will work with external vendors and/or internal stakeholders as a subject matter expert to analyze issues and resolutions. Mentors and develops staff. Also, CDI Director must have knowledge of current healthcare environment, understands and is accountable for ensuring a control environment is maintained to preserve Mayo's Standard of Ethics and minimize the financial and legal risks for Mayo. May work evening and weekend hours and travel as needed.

The CDI-Director role may support quality initiatives related to metrics, processes, policies, data integrity, and peer review activities identified as necessary by regulatory agencies e.g., CMS, OIG, AHRQ, etc.
Qualifications
  • Registered Nurse (RN with Bachelor’s Degree) with Certified Clinical Documentation Specialist CCDS through ACDIS/Certified Documentation Improvement Practitioner or CDIP through AHIMA, with at least 10 years of experience in the healthcare environment with a minimum of 5 years of experience managing CDI staff ; or
  • Certification by American Health Information Management Association (AHIMA) as a Registered Health Information Technician (RHIT) with CCDS/CDIP, with at least 10 years of experience in the healthcare environment with 7 years of experience managing CDI staff ; or
  • Registered Health Information Administrator (RHIA) with CCDS/CDIP, with at least 10 years of experience in the healthcare environment with a minimum of 5 years of experience managing CDI staff ; or
  • Bachelor's degree in accounting, finance, and health care business related fields, or business (e.g. communication, mathematics, business administration, or statistics) with at least 10 years of experience in the healthcare environment with a minimum of 5 years of experience managing CDI staff. Certified Coding Specialist (CCS) with CCDS or CDIP.
  • Knowledge and experience in Project Management is required.
  • Requires knowledge of Revenue Cycle Systems.
  • Must have excellent communication, organizational and human relation skills.
  • Requires excellent decision-making and judgment capabilities.
  • Must have experience in EMR use and budget tracking and monitoring of budget responsibility.
  • Knowledge reconciliation processes with a focus not only on DRG reconciliation but Quality reconciliation.
Additional qualifications
  • Extensive knowledge of physician and hospital billing systems for Governmental, managed care and commercial payers is preferred.
  • Excellent customer-service skills, oriented, timely in responses to requests for service/information, able to manage multiple tasks and priorities, have the ability to work independently and possess strong leadership skills. Needs experience in reconciling issues relating to clinical documentation and billing.
Exemption status
Exempt
Compensation Detail
Education, experience and tenure may be considered along with internal equity when job offers are extended.  The minimum salary every 2 weeks is approx $3,807.20, based on a full-time position.
Benefits eligible
Yes
Schedule
Full Time
Site description
Jacksonville is the largest city in area in the continental United States. A beautiful coastal Florida city that features excellent year-round climate, over 20 miles of beaches and outstanding outdoor recreational, cultural and family-oriented amenities. The “River City by the Sea” has an excellent school system, reasonable cost of living and a thriving business environment. Medical professionals and patients are drawn to Jacksonville by an extraordinary network of high-profile healthcare facilities. Jacksonville continues to grow as more people relocate from all over the U.S. and abroad, to see what the great River City has to offer!
Category
Administration, Business, Finance, Nursing
Job posting number
100526BR
Recruiter
Sarah Martin
Equal opportunity employer
Mayo Clinic is an equal opportunity educator and employer (including veterans and persons with disabilities).

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Director - CDI

Mayo Clinic
Jacksonville, FL

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Jacksonville, FL
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