Manager, Ambulatory Clinical Documentation Integrity; Remote

Manager, Ambulatory Clinical Documentation Integrity (Remote)

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.

Full time

St Clair Shores, MI $90,000.00-$

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.

• 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.

• 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.