As the Director of Clinical Documentation Integrity and Quality, you'll play a pivotal role in leading the coding and documentation oversight for pre-visit planning operations. Your primary focus will be to analyze existing processes, refine infrastructure, and facilitate seamless collaboration between internal teams and external partners to ensure the delivery of top-tier clinical care. This position offers an exciting opportunity to directly influence and engage with primary care delivery, both internally and externally.
Key Responsibilities:
Enhancing Pre-Visit Planning Processes: Evaluate, refine, and implement pre-visit planning processes to enhance efficiency and accuracy. Oversee the production of pre-visit planning materials, ensuring their relevance and suitability for all partners.
Quality Assurance: Develop and execute a robust quality audit process for pre-visit planning forms. Ensure timely distribution of these forms to partners and monitor their utilization, identifying areas for enhancement.
Expert Support: Serve as the primary point of contact for partner coding inquiries, demonstrating expert knowledge and problem-solving skills. Act as a documentation subject matter expert (SME), particularly in areas such as HCCs and ICD10 coding.
Team Management: Recruit, train, and manage a team of documentation coding supervisors and specialists. Foster a collaborative and supportive team environment.
Vendor Collaboration: Collaborate with documentation vendors to ensure seamless integration and performance, as well as assist in the implementation and management of technology platforms supporting clinical documentation processes.
Performance Monitoring: Develop and refine reporting mechanisms to monitor key performance indicators, identify trends, and make data-driven decisions. Work closely with stakeholders to implement workflow enhancements and new products.
Compliance and Regulatory Oversight: Develop and continuously improve coding compliance policies and guidelines, ensuring adherence to organizational, federal, state, and third-party requirements. Work closely with legal and compliance teams to address regulatory matters.
Travel: Travel may be required, up to 15% of the time.
Qualifications:
Possession of coding credentials such as CPC, CCS, CCS-P, RHIT, or RHIA. Outpatient CDI credential from AAPC or ACDIS preferred.
Auditing credential from AAPC or AHIMA preferred.
Minimum 6 years of risk adjustment coding, auditing, and management experience in CDI.
Expertise in CMS risk adjustment coding and RADV compliance standards.
Strong public speaking and presentation skills with a customer service orientation.
Experience in a team-based service environment with well-developed interpersonal skills.
Ability to work independently and adapt to a fast-paced environment.
Genuine curiosity and willingness to learn on the job.
Excellent communication skills and the ability to address non-compliance issues confidently.
Proficiency in Microsoft Office Suite and familiarity with coding and documentation platforms and major EHR systems.
Support and Benefits:
Competitive base pay with bonuses.
Generous paid time off starting at 4 weeks for full-time employees, pro-rated for part-time employees, and 12 paid holidays per year.
Reimbursement for continuing medical education.
401k with match.
Health, dental, and vision insurance.
Family-friendly policies supporting paid parental leave and flexible work arrangements.
Robust commitment to training and development throughout your career with us.
Join us and collaborate with like-minded healthcare professionals dedicated to delivering high-quality, value-based care. We look forward to welcoming you to our team!
Employment Type: Full-Time
Salary: $ 70,501.00 Per Year
