Manager, Ambulatory Clinical Documentation Integrity (Remote)

Employment Type: Full timeShift: Description: Purpose Accountable for leading, guiding & directing the functional responsibilities within an area of assignment. Enable ministry-level or enterprise-wide functional strategy to address internal or external business & regulatory issues. Provide functional expertise & ensure fulfillment of performance & service standards. Responsible for consistent operating performance & achieving financial goals. Identifies, defines & solves complex problems that impact the management & direction of the business. Collaborates with Services Areas, Regions & Health Ministries to ensure consistency & integration of strategy & operations while maintaining awareness of new industry developments & standards. Provides decision support, operations & / or optimization leadership focus. Essential Functions Our Trinity Health Culture: Knows, understands, incorporates & demonstrates our Trinity Health Mission, Values, Vision, Actions & Promise in behaviors, practices & decisions. Leadership: Providing advice, guidance & leadership to RHM & Region leaders in developing strategies & in the achievement of performance goals. Enable Collaboration across & within service area, RHM & Regions to ensure consistency & integration of strategy & operations Direction & Growth: Providing advice, guidance & leadership to service area, functional area, RHM & Regions. Leading standardization / systemness & optimization of policy, process, methodology, establishing a national community of practice. Oversee Vendor / Contract Labor Management including centralizing strategy & optimizing spend. Strategic Support & Accountability: Collaborates in system-wide strategy development & deployment of functional area priorities & initiatives. Responsible for supporting regional efforts to comply with functional area priorities. Accountable for the selection, evaluation & overall success of the functional leadership teams. Organization-wide focal point for establishing functional strategies & governance over financials & staffing. Accountable for communication between service area functional area, RHM & Region leaders. Operational Delivery Responsible for measuring & reporting KPIs / metrics &value delivery. Providing advice, guidance & leadership for the colleague life cycle. Maintains a Working Knowledge of applicable federal, state & local laws / regulations, Trinity Health Integrity & Compliance Program & Code of Conduct, as well as other policies, procedures & guidelines in order to ensure adherence in a manner that reflects honest, ethical & professional behavior & safe work practices. Functional Role (not inclusive of titles or advancement career progression) • Provides leadership & strategic oversight of the Trinity Health Medical Group’s (THMG) Ambulatory Clinical Documentation Integrity program. • Designs & builds structure, workflows & guidance of best practice documentation standards to ensure coding compliance & minimize audit liability. • Provides emphasis on adherence to CMS & other insurance carrier standards, optimizing revenues & the avoidance of monetary settlements from third party audits. • Works with providers & ambulatory practice leaders to develop accurate, effective, efficient & compliant documentation processes that ensure patient quality for all services provided & clinical documentation exists to support appropriate coding & billing. • Stays current with organizational alternate payment models & contracting to help prioritize work assignment for ambulatory clinical documentation integrity specialists. Develops & sustains working relationships with providers, advanced practice providers & administrators to promote success of the Clinical Documentation Integrity program. • Ensures educational materials & programs are available to staff & providers around complete & compliant documentation. • Assists in the development of software applications in assigned areas while identifying & resolving trends with process gaps causing errors in documentation. Minimum Qualifications • Bachelor’s degree in Business Administration, Healthcare Administration, Nursing or related field, or equivalent combination of education & experience • Experience with compliant healthcare documentation, HCC coding requirements, alternate payment models in a multi-facility, integrated health care delivery system, revenue cycle or consulting experience, with progressive responsibility in management or leadership experiences in clinical documentation integrity, coding, healthcare quality or equivalent • Certified Risk Adjustment Coder (CRC), Certified Clinical Documentation Integrity (CDI), Certified Clinical Documentation Specialist – Outpatient (CCDS-O), Certified Documentation Expert Outpatient (CDEO), or Certified Documentation Integrity Practitioner (CDIP) credential with coding or clinical documentation integrity experience • Ambulatory or outpatient experience with Medicare, Medicaid & other third-party billing rules & regulations Additional Qualifications (nice to have) • Master’s degree in nursing, HIM or related healthcare field Physical & Mental Requirements & Working Conditions (General Summary) Direct Healthcare Services / Indirect Healthcare / Support Services: • Exposure to conditions which may be considered unpleasant to sight, touch, sound & / or smell. Occasional • Exposure to fumes, odors, dusts, mists & gases, biohazards / hazards (mechanical, electrical, burns, chemicals, radiation, sharp objects, etc.). Occasional • Exposure to or subject to noise, infectious waste, diseases & conditions. Occasional • Exposure to interruptions, shifting priorities & stressful situations. Frequent • Ability to follow tasks through to completion, understand & relate to complex ideas / concepts, remember multiple tasks & regimens over long periods of time & work on concurrent tasks / projects. Continuous • Ability to read small print, hear sounds & voice / speech patterns, give / receive instructions & other verbal communications (in-person & / or over the phone / computer / device / equipment assigned) with some background noise. Frequent • Perform manual dexterity activities & / or grasping / handling. Occasional • Ability to climb, kneel, crouch & / or operate foot controls. Occasional • Use a computer / other technology. Frequent • Sit with the ability to vary / adjust physical position or activity. Continuous • Maintain a safe working environment & use available personal protective equipment (PPE). Continuous • Comply with applicable Code of Conduct, policies, procedures & guidelines. Continuous • Ability to provide assistance in the event of an emergency. Occasional Direct Healthcare Services: • Perform activities that require standing / walking with the ability to vary / adjust physical position or activity. Frequent • Lift a maximum of 30 pounds unassisted. Occasional • Use upper & lower extremities, engage in bending / stooping / reaching & pushing / pulling. Occasional • Work indoors (subject to travel requirements) under temperature-controlled & well-lit conditions. Continuous • Encounter worksites (e.g., patient homes) or travel to worksites that may have variable internal & external environmental conditions. Occasional • Perform work that involves physical efforts (e.g., transporting, moving, positioning & / or ambulating patients). Occasional Indirect Healthcare / Support Services: • Perform activities that require standing / walking with the ability to vary / adjust physical position or activity. Occasional • Lift a maximum of 30 pounds unassisted. Occasional • Experience of long periods of walking / standing / stooping / bending / pulling & / or pushing. Occasional • Encounter a clinical / patient facing / hands on interactive work environment. Occasional • Work indoors (subject to travel requirements) under temperature-controlled & well-lit conditions. Continuous • Work outdoors with variable external environmental conditions. Occasional Average Workday Activity: Occasional - O (1% - 33%), Frequent - F (34% - 66%), Continuous - C (67% - 100%) The above statements provide a representative description of the nature & level of work being performed by persons assigned to positions within this job description. This is not an exhaustive list of essential functions, conditions & duties; other job-related tasks may be required. Additional detail may be provided by policies, procedures, guidelines, protocols, standards & other communications. Requests for reasonable accommodation will be considered in compliance with federal, state & local law. Our Commitment Rooted in our Mission and Core Values, we honor the dignity of every person and recognize the unique perspectives, experiences, and talents each colleague brings. By finding common ground and embracing our differences, we grow stronger together and deliver more compassionate, person-centered care. We are an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or any other status protected by federal, state, or local law. Apply tot his job Apply To this Job