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Summary
To be part of our organization, every employee should understand and share in the MyMichigan Health Vision, support our Mission, and live our Values. These values include excellence, integrity, teamwork, and accountability and must guide what we do as individuals and professionals.
The CDI Supervisor at the direction of the Manager of Clinical Documentation Integrity will assist in the supervision of daily operations of the inpatient (IP) and ambulatory (AMB) CDI programs.
Working with the Manager of Clinical Documentation integrity will assist with policy and education development on the use of guidelines and proper documentation requirements as it relates to reimbursement and other clinical data for colleague training. Provides quality and productivity monitoring; coordinates and participates in performance improvement initiatives to include provider education and training.
Provides training and education to IP and AMB clinical documentation specialists (CDSs) to enhance clinical and coding skill sets and optimal utilization of associated software to perform role.
Works closely with Clinicians, Coding, Quality, and Denials teams to facilitate documentation within the medical record to support proper reimbursement and risk adjustment.
Responsibilities
(25%)* Maintains current knowledge of the MS-DRG system, CCs/MCCs, impact on quality, risk of mortality, severity of illness and CMI as well as ICD-10 coding systems and the guidelines related to Clinical Documentation Integrity.
(25%)* Understands risk adjusted payment methodologies, HCC assignment and payment methodology, professional coding and billing, outpatient facility coding and billing, and OPPS reimbursement methodology and shares this knowledge with colleagues and clinical team members.
(25%)* Assists the Manager of Clinical Documentation Integrity in the recruitment, retention and supervision of IP and AMB CDI staff. Participates in the development of staff, including fostering teamwork, providing performance feedback, mentoring CDS and scheduling education
(25%)* Communicates with and educates physicians and all other members of the healthcare team regarding clinical documentation and monitors provider participation. Identifies learning opportunities for healthcare providers. Ensures that direct reports communicate, educate and engage with physicians and other members of the healthcare team regarding clinical documentation.
Certifications and Licensures
Credential:RN: Registered Nurse
Equivalent Experience: One of the following are required or must be obtained within 2 years of hire:Certification of Clinical Documentation Specialists (CCDS)Certification of Clinical Documentation Specialists Outpatient (CCDS-O)
Qualification Source: MI
Essential: true
Required Education
Education: BACH
Equivalent Experience: Bachelor’s Degree in Nursing required.
Education Specialization: NRG
Essential: true
Other Information
Other Duties and Responsibilities:
Development of IP and AMB CDI provider education to include presentations to department, provider practices, and individual providers education (to include new provider education)
Data analysis to identify trends and opportunities for improvement: PEPPER Reports, Mortality, Readmission etc.
Denials and appeals management oversight of process and utilization of case information to drive provider education
Perform CDI reviews as required to support program during high volumes
Staff Development to include precepting new staff, audits, and focused individual/group education
Leads and/or actively participates in meetings. Actively participates in department performance improvement and employee engagement activities.
Performs all other duties or special projects requested by leadership and proactively communicates any problems that arise to maintain a smooth operation of the department.
Exhibits enthusiasm for the profession, embraces educational opportunities and department support offered and remains engaged in the goals and the vision of the department. Role models the professional standards of behavior and encourages all staff to do the same.
EXPERIENCE, TRAINING AND SKILLS
Minimum of five (5) years of current hospital clinical documentation improvement program experience is required
Leadership skills needed to effectively lead a team.
Must have thorough knowledge of CMS regulations to include coding guidelines, DRG reimbursement, and Risk adjustment to include HCC/RAF coding and documentation requirements.
Demonstrated knowledge of state and federal Hospital Acquired Conditions (HAC) and other applicable quality indicator codes (i.e. PSI, PPI, etc.).
Written and verbal communication skills necessary to interact successfully with individuals and groups at levels of the organization in order to share ideas, concepts, and actions in a clear and understandable manner.
Demonstrate expertise with IP and AMB CDI software applications.
Mandatory tuberculosis (TB) testing must be done annually.
Mandatory Occupational Safety and Health Administration (OSHA) training must be completed annually
according to the Exposure Control Plan.
MyMichigan Health is a technology driven organization and employees need to demonstrate competency
in Microsoft Windows.
An employee may be required to participate in further learning opportunities offered by MyMichigan Health.
Physical/Mental Requirements and Typical Working Conditions
Exposure to stressful situations
Able to wear personal protective equipment that includes latex materials or appropriate substitute if required for your position.
Is able to move freely about the facility with or without an assisted device and must be able to perform the functions of the job as outlined in the job description.
Overall vision and hearing are necessary with or without assisted device(s).
Frequently required to sit/stand/walk for long periods of time.
Ability to handle multiple tasks, get along with others, work independently, regular and predictable attendance and ability to stay awake.
Overall dexterity is required including handling, reaching, grasping, fingering, and feeing.
May require repetition of these movements on a regular to frequent basis.
Physical Demand Level: Sedentary.
Physical Demand Level: Light. Must be able to occasionally (0-33% of the workday) lift or carry 11-20 lbs.,
Equivalent Experience and Other Comments (Education)
Education: BACH
Equivalent Experience: Bachelor’s Degree in Nursing required.
Education Specialization: NRG
Essential: true
Other Comments
Credential:RN: Registered Nurse
Equivalent Experience: One of the following are required or must be obtained within 2 years of hire:Certification of Clinical Documentation Specialists (CCDS)Certification of Clinical Documentation Specialists Outpatient (CCDS-O)
Qualification Source: MI
Essential: true
