Manager-Clinical Documentation Improvement Specialist

Primary Function

• Directly manage all aspects of the Clinical Documentation Improvement Program at Jefferson Hospital Einstein including the Clinical Documentation Specialist staff at all Einstein Acute Care Campuses, under the direction of the Assistant Vice President of Health Information Management (HIM).
• Responsible for ensuring optimum coverage for all inpatient cases under review as well as accurate and compliant queries to the medical staff.
• Responsible for training of the medical staff on documentation improvement opportunities.
• Responsible for training new CDI staff as well as providing ongoing education of existing CDI staff. Works with HIM Management Team on special projects and with IS on CDI tracking system enhancements and assists in resolving CDI tracking system technical issues.
• Coordinates and conducts education regarding changing DRG requirements and the CDI processes. Through extensive interaction with physicians and multidisciplinary team members, the CDI manager will be responsible for facilitating ongoing evaluation and program improvements to ensure the overall quality and completeness of medical record documentation.
• This will support the appropriate clinical picture/level of severity of the patient while providing accurate and complete information that is utilized in the medical record abstraction and coding process.

Qualifications

Education/Training/Experience

• Minimum of three years’ experience as an inpatient/acute care Clinical Documentation Improvement Specialist in a large academic medical center, health system required.
• Strong working knowledge and experience in clinical record reviews required.
• Expert level working knowledge of ICD-10-CM/PCS coding conventions and SOI/ROM and DRG system required.
• Excellent interpersonal and communication skills with previous experience working collaboratively within Teams required. Ability to work remotely and manage participation in multiple committees.
• Prior data analytic skills and understanding CMI and DRG/APR system required. Strong working knowledge of Microsoft Office (Outlook, Word, Excel, PowerPoint) required.
• Excellent written and verbal communication skills with the ability to write and speak concisely and professionally when communicating with providers and hospital leadership.
• Self-motivated with strong critical thinking and problem-solving skills. Must possess the ability to create and deliver clinical education programs on CDI to the CDI staff, medical and hospital staff.