Manager, Clinical Documentation Integrity - Remote

At e4health, we Empower Better Health. The e4health Team is on a relentless mission to care for those teams who care for others. We bring our passion, ingenuity, and expertise to every engagement. In joining our Team, we want your help to provide our customers with powerful solutions in the pursuit of quality, integrity, clinical and financial value across healthcare.

Our People make the difference. Serving more than 400 hospitals and health systems nationwide for nearly two decades, e4health provides solutions to tackle the toughest problems in healthcare with unmatched technology, mid-revenue cycle, and operational expertise. e4health solutions streamline clinical, financial, and health information data and workflows, optimize coding, quality, and clinical documentation integrity processes, and address health IT operational challenges to deliver material results for healthcare organizations across the country. Learn more about us at www.e4.health.

Manager, Clinical Documentation Integrity - Remote

JOB SUMMARY:

The Manager of Clinical Documentation Integrity (CDI) will provide consulting services to clients in the areas of inpatient and outpatient CDI program support, development, training, process improvement, auditing, or education nationwide (onsite and remote). The ability to actively perform reviews for clinical documentation improvement is required.

The Manager of Clinical Documentation Integrity will be responsible for developing e4health methodology to client responses related to audits, program assessments, and evaluation of quality and performance metrics. The Manager of CDI will also be responsible for risk mitigation and assist with plans of correction, action plans, as well as education. This position will work closely with the Vice President of Clinical and Quality Services to build the Clinical Documentation Integrity (CDI) methodology to incorporate denials/appeals management. The role of the Manager of CDI is to assist the inpatient (IP) and outpatient (OP) CDI teams in leveraging client data to determine CDI opportunity and creation of key performance indicators (KPI).

ESSENTIAL DUTIES AND RESPONSIBILITIES:

• Development of the e4health methodology/service line related to documentation integrity
• Provides solutions to complex business problems for area(s) of responsibility where analysis of situations requires an in-depth knowledge of organizational objectives
• Client Relationship Development: Develop and leverage existing relationships with potential clients through personal meetings, presentations, speaking engagements, business networking, emails and/or other business or social outings
• Client Demand Stimulation and Opportunity Generation: Identify specific sales opportunities within existing and prospective clients. Engage in activities focused at generating client awareness of e4health and/or demand for its Services
• Involved in setting strategic direction to establish near term goals for area of responsibility
• Interacts with senior management levels at a client and/or within e4health
• Has latitude in decision-making and figuring out objectives and approaches to critical assignments
• Decisions have a lasting impact on area of responsibility with the potential to impact outside area of responsibility
• Manages teams and/or work efforts (if in an individual contributor role) at a client or within e4health
• Works at appropriate level of independence and works within scope of position and direction
• Demonstrates professionalism and accuracy in completing responsibilities within deadlines
• Manages time, prioritizes and organizes work effectively
• Maintains confidentiality, security and standards of ethics with all e4health and Client information
• Client’s needs will also determine specific responsibilities, additional responsibilities may include but not limited to:
• Analyze and interpret medical record documentation and to formulate compliant physician queries to improve the quality, completeness and accuracy of the patient’s medical record
• Perform and/or lead Inpatient and/or Outpatient CDI Assessments
• Communicate with clients and provide client support (as needed)
• Review and analyze client data and execute projects including reporting to clients
• Assist in the design and presentation of educational sessions to clients and staff
• Provide initial and on-going training and education for Inpatient and Outpatient CDI staff at client sites

REQUIRED QUALIFICATIONS:

• Must possess an RN, BSN, RHIA, RHIT, or CCS certification or combination thereof
• A CCDS or CDIP credential is also required
• A minimum of five years of experience in nursing or other clinical area, coding, process improvement, or utilization review/case management in an acute care facility
• A minimum of five years of experience in healthcare revenue cycle management (ie. Clinical documentation improvement, health information management, etc.)
• Must have a strong background in coding skills with experience in ICD-10 and working knowledge of the AHA Coding Clinic
• Comprehensive understanding of clinical and revenue cycle processes in a healthcare setting, managed care plans, insurance carriers, quality and performance metrics, ICD-10, coding, and documentation guidelines
• Effective interpersonal skills to interact effectively with all levels of hospital personnel.
• Proficient understanding of technology software and hardware as well as other general computer skills.
• Previous experience in a Supervisory or Management role
• Previous experience educating, mentoring, or leading workgroups
• Ability to travel may be required up to 15% of the time.

KEY SUCCESS ATTRIBUTES: 

• Integrity, passion, and ethics are required
• Demonstrates strong collaboration skills
• Has strong organizational, analytic, and problem-solving abilities and techniques
• Exhibit consistent initiative with strong drive for results and success
• Demonstrate commitment to a team environment 
• Demonstrate excellent interpersonal skills 
• Well-developed written, verbal, and presentation communication skills including deep listening and attention to detail.
• Ability to self-motivate and self-direct.
• Possess strong time management and organizational skills.
• Commitment and adherence to company Core Values

CORE COMPETENCIES:

• Personal Accountability
• Analysis of Data
• Self-Direction
• Problem Solving Ability
• High level of integrity & ethical judgement

BENEFITS:

We offer an excellent salary, full benefits package including 401(k) with company match and discretionary profit sharing, group medical, dental, vision, life, & short-term disability insurance, and PTO policy.

PHYSICAL DEMANDS OF THE ESSENTIAL FUNCTIONS:

Sitting, talking, hearing and near vision are required over 90% of the time. Feeling is required over 90% of the time and reaching is required about 50% of the time. Ability to lift 20 pounds. Ability to sit for prolonged periods of time. Ability to focus/read a computer screen for prolonged periods. Position may involve working inside a hospital facility. Basic sensory skills: Visual, auditory and speech acuity. OSHA Exposure Category III - no risk of exposure to blood or body fluids. Over 90% of the time is spend indoors, with protection from weather conditions. 

WORKING CONDITIONS WHILE PERFORMING ESSENTIAL FUNCTIONS:

Over 90% of the time is spent indoors, with protection from weather conditions. Exposure to noise levels that may be distracting or uncomfortable is present in only unusual situations.

e4health is an equal opportunity employer and will consider all applications without regard to race, color, religion, national origin, ancestry, marital status, veteran status, age, disability, pregnancy, genetic information, gender, sexual orientation, gender identity or any other legally protected category.

Applicants for U.S. based positions with e4health must be legally authorized to work in the United States. Verification of employment eligibility will be required at the time of hire. Visa sponsorship is not available for this position.