Clinical Documentation Improvement Manager - Mount Sinai Health Partners

The Clinical Documentation Improvement Manager (MSHP) with oversight from the Director shall be responsible for the daily oversight of staff to meet departmental and corporate objectives to ensure that all patient charts are documented and coded to the highest specificity. This includes planning, monitoring, review and evaluation of the department policies and procedures. The Manager will be responsible for ensuring compliance with the Standard Operating Policy, adherence to milestones and timely execution of deliverables. This position will also be responsible for the review of the monthly processes and analysis, and preparation of reporting packages.  They will provide direct oversight for the CDQI Specialists for day-to-day workflow and other management related needs. The Manager will track and trend coding and documentation issues, develop targeted provider education, and create best practices for medical record review and diagnosis code abstraction. The incumbent will work closely with all departments within Mount Sinai Population Health.  The Manager will assist the Director to ensure that all governmental and compliance requirements are met. 

•    Systematically evaluates the quality and effectiveness of the CDQI department analyzing appropriate internal and external data and information to identify opportunities for improving CDQI practices.
•    Provides on-going feedback to CDQI staff regarding the quantity and quality of concurrent queries.  Provides suggestions as to opportunities for additional and/or more appropriate queries.  Addresses CDQI staff questions.  Along with Analytics, develops mechanisms for auditing quality of CDQI queries on an ongoing basis.
•    Develops implements and evaluates documentation and query tools with CDQI staff and medical care teams. Conducts annual review of tools content based upon changes in ICD-10 codes and revises or develops new tools as needed. Based upon audit results, provides feedback to medical teams which could enhance the accuracy of patient record documentation.
•    Provides status reports of the department. Maintains and interprets master CDQI report package for trends, accuracy and performance improvement.
•    Decisions and actions are based on ethical principles and foster a non-discriminatory climate.
•    Responsible for interviewing and hiring.
•    Responsible for operating within approved budget.
•    Provides leadership, direction and guidance to staff.
•    Coordinates and maintains the required training and skills for staff.
•    Implements corrective actions and conducts performance evaluations.
•    Effectively addresses personnel issues in order to promote a productive and healthy and positive work environment.
•    Performs other duties as assigned or required
 

Education Requirements                                         
•    Associates degree required.  Bachelor’s degree preferred.

Experience Requirements                                        

•    Minimum of 3-5 years senior-level, training or supervisory experience on a team that focuses on clinical documentation and/or coding required. This experience should include but is not limited to, experience with training and onboarding new team members, serving as a mentor, monitoring work product, delivering feedback, and overseeing a quality review process. 
•    Relevant AAPC, AHIMA or ACDIS certification required i.e. CCS (Certified Coding Specialist), CPC (Certified Coding Professional), CIC (Certified Inpatient Coder) or CCDS Certified Clinical Documentation Specialist 
•    CRC (Certified Risk Adjustment Coder) strongly preferred. Must obtain within one year.
•    Minimum three (3) years in a health care setting is required. 
•    Minimum one (1) year of experience reviewing records and accurately applying ICD-10-CM diagnosis codes. 
Additional Skills and Qualities
•    Verifiable ability to effectively communicate on a verbal and written basis with staff, management and providers is required. 
•    Demonstrated ability to determine, analyze and solve escalated issues related to medical record documentation and coding deficiencies required. 
•    Ability to interpret ICD-10, CMS and HHS guidelines. 
•    Advanced knowledge of Microsoft Office, including Word, Excel, Outlook and PowerPoint is preferred  
•    Demonstrated ability to pro-actively identify problems, as well as recommend and/or implement effective solutions. 
•    Demonstrated ability to identify improvement opportunities for processes and reports. 
•    Must be detail-oriented with strong organizational skills, including the ability to coordinate workflow. 
•    Demonstrated ability to lead, coach, train or supervise staff. 
•    Demonstrated ability to work independently and with a team to contribute to department goals. 
•    Excellent verbal and written communicat