When you join the growing BILH team, you're not just taking a job, you’re making a difference in people’s lives.
Under the direction of the Beth Israel Lahey Health (BILH) Vice President, Mid-Revenue Cycle, the Director of Clinical Document Improvement (CDI) is primarily responsible for managing all employees and activities within the Clinical Documentation Program for multiple facilities across the BILH organization. This role will assist in leading continuous improvement in documentation strategies by working closely with the Chief Medical Officers, Physician Advisors, and employed physicians. The Director of CDI will also be accountable for direct oversight of the CDI team members, which includes hiring, onboarding, and continued training. This leader will monitor the success of the team by trending metrics such as CMI, MCC capture, and service line DRG opportunities. This role will manage staffing dependent on the needs of the facility. This leader will be involved in the direction and education of all phases of the Clinical Documentation Specialist role and provide feedback through internal audits and continuous feedback.
Job Description:
Essential Duties & Responsibilities including but not limited to:
• Report monthly CDI metrics, trends, and opportunities to the CDI leaders and CDI Steering Committee.
• Ability to interpret CDI metrics and trends that result in needed outcomes
• Evaluate the CDI program initiatives via ongoing metric analysis, tracking, and report findings.
• Collaborate with the CDI team to help identify patterns, trends, and variations in clinical documentation and code assignments.
• Demonstrate a strong understanding of case mix index, MCC/CC capture, the severity of illness/risk of mortality, LOS, risk adjustment diagnoses.
• Participate in multi-disciplinary meetings as it relates to CDI involvement.
• Identify the need for additional training and resources needed for the success of the CDI team.
• Provides concentrated daily oversight and direction to the Clinical Documentation Specialists and the Clinical Documentation Improvement Team and Program.
• Reviews inpatient medical records prospectively to ensure that the care of the patient is recorded in language that payers can interpret and which accurately and completely depicts the acuity of the patient and resources expended.
• Reviews surgical procedures to ensure documentation is accurate for ICD/10-PCS code assignments. Operationalizes and institutionalizes documentation practice that accurately and completely depicts the acuity of the patient and resources expended. All methods adhere to coding clinic and hospital compliance guidelines.
• Create and implement training and development for nursing staff, physicians, and mid-level practitioners that addresses documentation issues & variances.
• Works in association with the CDI clinicians, coders, and all members of the healthcare team to ensure accurate and timely clinical documentation in the medical record.
• Develops, maintains, and improves upon effective and accurate IS systems for managing, tracking, and analyzing data (including working with Fiscal IS Decision Support).
• Tracks DRG assignments against national benchmarks to identify documentation variances.
• Identifies potential solutions, whether general education or targeted interventions, where inconsistencies can be improved upon and rectified.
• Reviews payer denials. Assists in the preparation of appeals to payers, where appropriate.
• Develops an intervention to prevent subsequent denials for the same problem, where ambiguity or incompleteness of documentation has led to a denial.
• Provides ongoing education to Clinical Documentation Specialists on clinical topics.
• Periodically reviews and updates Clinical Documentation policies and guidelines.
Minimum Qualifications:
Education: Bachelor’s degree in Nursing or MBBS required.
Licensure, Certification & Registration: CCDS required within 6 months of hire
Experience: Minimum 5 years of experience in CDI and/or Coding with progressive leadership roles
Skills, Knowledge & Abilities:
• Experience with Microsoft Office 365
• Excellent communication and interpersonal skills
• Knowledge of Epic environment, 3M encoder
• Working knowledge of ICD-10 CM and PCS Coding and IPPS
• Strong planning and problem-solving skills
• Ability to analyze information and processes
• Motivation to develop and maintain internal and external relationships
• Interpretation of data that lends to strategic leadership
• Expert understanding of quality metrics such as PSIs, HACs, and mortalities
Preferred Qualifications & Skills:
Master’s degree in Nursing, Healthcare Administration, or other healthcare related
Pay Range:
$159,994.00 USD – $184,995.00 USD
The pay range listed for this position is the annual base salary range the organization reasonably and in good faith expects to pay for this position at this time. Actual compensation is determined based on several factors, that may include seniority, education, training, relevant experience, relevant certifications, geography of work location, job responsibilities, or other applicable factors permissible by law.
