The Director of Clinical Documentation Integrity impacts all acute care hospital Clinical Documentation Integrity programs, which generate $60M to $85M of revenue annually by ensuring documentation accurately reflects the patient’s condition.
This individual provides strategic leadership and operational oversight for all acute care programs and is directly accountable for each Health Ministry (HM) achieving industry best practices and key performance indicators as well as financial targets. This position influences, initiates, directs, and oversees clinical documentation integrity program activities that include productivity, quality, education, compliance and technology enhancements. The Director works closely with the Vice President of Mid-Revenue Cycle to establish strategic initiatives to drive improvement as well as updating leading and lagging performance indicators.
This position works closely with Health Ministry Regional Chief Financial Officers, Chief Clinical/Medical Officers, Physician Champions, Quality and Coding leaders to create and implement standards of documentation that support a full and accurate representation of the patient’s health status, risk factors, patient care rendered to enable management of individual patients and populations through the continuum of care. The Director of CDI is accountable for providing regular communication to the HM Regional CFOs as it relates to their program’s performance.
ESSENTIAL FUNCTIONSUnderstands, incorporates, and demonstrates the mission, vision, and values of the Ministry in leadership behaviors, practices, and decisions.
Develops, implements and monitors consistent operational processes for CDI management and staff across Trinity.
Ensures that all CDI staff are meeting Trinity’s productivity and quality standards.
Manages the recruiting, hiring and evaluation process for all CDI management and staff.
Oversees development of educational materials for CDI staff as well as physicians.
Leads collaborative process with physicians, case management, CDI leaders and clinical documentation specialists to develop strategies to create standards of documentation that support a complete and accurate record of patient care rendered, severity of illness, risk of mortality and resources consumed across the continuum of care.
Directs optimization of Clinical Documentation Integrity technology/software and monitors new features/changes in software functionality and develops strategy for implementation of updates. Effectively collaborates with information technology colleagues to ensure that changes are appropriately implemented and issues are resolved quickly.
Establishes and monitors performance metrics for documentation integrity initiatives and programs across the continuum, including enterprise key performance indicators and various enterprise reports that outline operational performance, quality, and financial value.
Responsible for designing and implementing enterprise documentation standards for all care settings and policies and procedures that meet compliance and regulatory guidelines.
Identifies strategic objectives for ongoing documentation integrity activities and ensures program priorities are in alignment with CDI industry evolution and support enterprise clinical and revenue strategic initiatives.
Cultivates a positive, professional interdepartmental relationship with HIM directors, coding team, case management, quality, and medical staff to support initiatives that advance system objectives.
Educates clinical documentation specialists, coders, physicians, clinicians and the department leaders on compliant documentation integrity opportunities, severity of illness, risk of mortality, clinical evidence documentation, charge capture, referral management, and appropriate resource consumption.
Analyzes MS-DRG, APR-DRG, Severity of Illness, Risk of Mortality, PEPPER, and audit appeal/denial data to identify strategic opportunities.
Creates a culture that is patient and employee centric and focused on excellence and continuous process improvement.
Maintains a working knowledge of applicable Federal, State, and local laws/regulations; the Trinity Health Integrity and Compliance Program and Code of Conduct; as well as other policies and procedures to ensure adherence in a manner that reflects honest, ethical, and professional behavior.
LEADERSHIP COMPETENCIES
As a Trinity Health Leader, the incumbent is expected to demonstrate leadership traits which support our Mission Statement and Core Values as identified below:
Mission Statement: We, Trinity Health, serve together in the spirit of the Gospel as a compassionate and transforming healing presence within our communities.
Core Values:
Reverence: We honor the sacredness and dignity of every person.Commitment to Those who are Poor: We stand with and serve those who are poor, especially those most vulnerable.Justice: We foster right relationships to promote the common good, including sustainability of Earth.Stewardship: We honor our heritage and hold ourselves accountable for the human, financial and natural resources entrusted to our care.Integrity: We are faithful to those we say we are.Hourly pay range: $73.5184 - $121.3054
MINIMUM QUALIFICATIONSBachelor degree in healthcare or equivalent combination of education and experience. Master's degree in Health Administration or Business Administration preferred. Certification as one of the following: Registered Health Information Technician (RHIT), Registered Health Information Administrator (RHIA), Certified Clinical Documentation Improvement Specialists (CDIS) or Certified Documentation Improvement Practitioner (CDIP) required.
Minimum of fifteen (15) years of progressively responsible operational or management experience in health information management or case management/utilization review with direct supervisory experience required. Broad spectrum of clinical, financial, hospital and payer knowledge and experience required.
Previous Senior Leadership experience at the corporate or enterprise level required.
Previous leadership experience in ambulatory care and physician office settings preferred.
Previous experience and working knowledge of Population Health Management, Clinically Integrated Networks and Health Insurance Exchanges preferred.
Must have demonstrated experience with leading documentation integrity strategic initiatives across multiple facilities along with physician, CDI specialists and coder involvement.
Must have thorough knowledge of rules and regulations surrounding documentation compliance.
Project management and/or system implementation experience required.
Must possess strong analytical skills to understand clinical documentation issues and how they impact revenue cycle and quality metrics.
Ability to influence and engage direct and indirect reports as well as peers to achieve results.
Excellent interpersonal skills with ability to build collaborative working relationships with clinical staff, finance and compliance.
Excellent written and oral communication skills; ability to write clearly and succinctly in a variety of communication settings and styles.
Ability to address complex problems with multi-level impacts using sound judgment, in-depth analysis and expertise to resolve issues.
Strong knowledge of IT applications and technology and their impacts on productivity and workflow.
Ability to create and implement business strategies and processes to address changing healthcare environment and reimbursement.
Strong knowledge of HIPAA, CMS regulations and other compliance requirements as well as ICD-10, and CPT 4 coding classification systems.
Maintains professional attitude and ability to relate well with executive management, physicians, other care providers, colleagues, and patients.
Strong understanding of the Catholic health ministry in an evolving health care delivery system and changing reimbursement market.
Personal presence that is characterized by a sense of honesty, integrity, and caring as well as the ability to inspire and to motivate others to promote the philosophy, mission, vision, goals, and values of the Trinity Health Ministry.
PHYSICAL AND MENTAL REQUIREMENTS AND WORKING CONDITIONSAbility to work in a fast-paced, multi-customer environment, with conflicting needs. May warrant varied and/or extended hours, with changes in workload and priorities to keep pace with the industry and advanced strategic priorities.
Must possess the ability to comply with enterprise policies and procedures.
Must be able to spend majority of work time utilizing a computer, monitor and keyboard.
Travel may be required to the various Ministry locations.
The above statements are intended to describe the general nature and level of work being performed by persons assigned to this classification. They are not to be construed as an exhaustive list of duties so assigned.
Our Commitment to Diversity and Inclusion
Trinity Health is one of the largest not-for-profit, Catholic healthcare systems in the nation. Built on the foundation of our Mission and Core Values, we integrate diversity, equity, and inclusion in all that we do. Our colleagues have different lived experiences, customs, abilities, and talents. Together, we become our best selves. A diverse and inclusive workforce provides the most accessible and equitable care for those we serve. Trinity Health is 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, status as a protected veteran, or any other status protected by law.