Clinical Documentation Integrity Lead - Service Line (Remote)

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Day - 08 Hour (United States of America)

This is a Stanford Health Care job.

A Brief Overview
The Clinical Documentation Integrity (CDI) Service Line Outcomes Lead is responsible for partnering with service line & physician leadership to optimize documentation tools, improve processes, and develop strategies to reduce administrative burden on our providers, while maintaining high quality and integrity documentation. This leader will serve as a direct partner to service line leaders with the aim to improve query turnaround, identify & facilitate targeted education opportunities, and strengthen overall buy-in and engagement.

Locations
Stanford Health Care

What you will do

• Responsibility for management and optimization of the positive relationships between CDI and the service lines assigned, meeting regularly with SL Physician Champion and Chair/Chief.

• Drive increased workflow efficiency through monitoring and escalating queries as appropriate.

• Performance of CDI targeted audits and analysis of the findings, related to documentation and coding, to build physician education, identify areas of individual and service line opportunity, and facilitate short and long-term resolutions.

• Serve as a subject matter expert and authoritative resource on interpretation and application of CDI practices, coding rules and regulations, and conducts risk assessments of potential and detected compliance deficiencies, as well as documentation opportunities within the service lines assigned.

• Assists in monitoring and evaluating CDI and coding quality in relationship to best practices, while completing project-related reviews and providing relevant feedback to peers, coding, CDI leadership and quality partners, as necessary.

• Coordinates data collection and analysis, in collaboration with quality teams, related to patient care activities, documentation opportunities, coding opportunities and clinical outcome performance gaps.

• Coordinates the development of working sessions of multi-disciplinary teams in goal setting and problem solving.

• Optimizes service line clinical documentation integrity programs, including related provider and multidisciplinary education content creation, delivery and evaluation of effectiveness.

• Leads multidisciplinary and multi-departmental CDI projects to achieve strategic goals and objectives.

• Partners with other CDI leads, IT and other technology partners to create and optimize documentation tools, process and strategies to reduce administrative burden on our providers, while maintaining high quality and integrity documentation.

Education Qualifications

• Bachelor’s degree in Nursing, Medicine, Health Information Management or similarly related field of study.

• At least two currently active:
  
  - COC, CPC, or CCS certification
  
  - Certified Data Management Professional (CDMP) certification, Certified Analytics Professional (CAP) certification, or similar
  
  - CRCR or other revenue cycle certification
  
  - Health Care Quality (HACP, CPHQ, HCQM) certification
  
  - Case Management Certification (CCM) or clinical certification
  
  - Physician Educator Certificate Program (PECP) certification, or other education certification

Experience Qualifications

• Five (5) years of progressively responsible and directly related inpatient clinical experience. At least 5 years of CDI, or provider education related work experience. Outcomes data reporting and analysis experience.

• ICU/ED and Academic Medical Center experience preferred.

• Case management, utilization review and/or direct provider interaction experience, preferred.

• Experience in public speaking, as well as educational content creation and delivery of formal multidisciplinary education, preferred.

• Experience with Vizient, Premier, Elixhauser and other risk adjustment methodologies, highly preferred.

Required Knowledge, Skills and Abilities

• Expertise in coding and CDI practices., maintaining expertise in Medicare/Medicaid rules and regulations, as well as current trends and developments.

• Knowledge of, but not limited to, current CMS coding guidelines and methodologies, MS-DRGs, APR-DRGs, HCCs; current version of CM/PCS and AMA CPT coding guidelines and conventions, staying abreast of CMS rules and regulations and incorporating those change