Director, Clinical Documentation Integrity - Remote| Exton, Pennsylvania | Remote

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities.

Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together.

The Service Area Director, Clinical Documentation Integrity, directs the activities of the Clinical Documentation Integrity (CDI) department. The selected candidate is responsible for providing CDI program oversight and day-to-day implementation of processes related to the concurrent review of the clinical documentation in the inpatient medical record of Optum Insight Client patients (Allina, Pro Health and Queens' Health) at multiple hospitals. This includes, but is not limited to, overall responsibility for the planning, administration, control and quality management of the CDI Department activities in addition to regular reporting of department progress and initiatives to hospital leadership.

This position collaborates with providers and other healthcare team members to make improvements that result in accurate, comprehensive documentation that reflects completely, the clinical treatment, decisions, and diagnoses for the patient. This position utilizes clinical expertise and clinical documentation improvement practices and facility specific tools for best practice and compliance with the mission/philosophy, standards, goals and core values of Optum. The Service Area Director of CDI does not have patient care duties, does not have direct patient interactions, and has no role relative to patient care.

The Clinical Documentation Integrity (CDI) Director to lead multi-site CDI programs across hospital systems in Pennsylvania, Massachusetts, and New York.

This is a high-impact leadership role responsible for driving CDI program performance, partnering with hospital executives, and leading distributed clinical teams across multiple facilities.

The CDI Service Area Director is involved in the education of all phases of the Clinical Documentation Improvement process across a service area. Provides ongoing Clinical Documentation Improvement education for physicians & new staff and new initiatives or identified areas of knowledge deficit. Tracks and trends program compliance to determine areas of focus for educational opportunities.

You'll enjoy the flexibility to work remotely
* from anywhere within the U.S. as you take on some tough challenges.

What You'll Do

• Lead CDI operations across multiple hospital systems (PA, MA, NY)
• Manage ~15+ FTEs, including direct and indirect reports
• Drive performance through KPIs, analytics, and reporting
• Partner with hospital leadership (CMO, CFO, physicians) to improve documentation quality
• Lead client-facing discussions, presentations, and escalations
• Develop and execute CDI education initiatives for providers and staff
• Oversee staffing, workflows, compliance, and program outcomes

Primary Responsibilities:

• Operations, business, financial, and human resource needs of the CDI department
• Plan daily operations of the department in conjunction with the AVP of CDI and participate in development of objectives to meet KPI's
• Direct and maintains adequate staffing and workflow to meet CDI needs
• Monitor various reports and productivity to ensure that production standards and objectives are met in areas of responsibility
• Lead the CDI program as demonstrated by assuming accountability for the ongoing success of the Clinical Documentation Program. Monitors CDI program and communicates with appropriate facility leadership regarding CDI key performance indicators (KPIs), and identifies and implements process changes to maintain and improve KPIs
• Engage and consult with Physician Advisor and/or CMO to resolve provider issues regarding answering clarifications and participation in the clinical documentation improvement process
• Serves as a resource to Physicians / Case Managers and other key professional staff in matters relating to clinical documentation improvement & ICD-10
• Works with medical records, quality, finance, and physician groups to develop systems to facilitate complete documentation for data reporting purposes
• Develops and monitors strategic operating goals, objectives and budget; and reports operational performance, justification and/or corrective action
• Develops and manages direct reports; and oversees the development and management of indirect reports
• Builds and maintains productive inter/intra departmental and vendor work relationships to optimize operations
• Oversees compliance with government and agency regulations Performs related duties, as required
• Provide ongoing Clinical Documentation Improvement education for providers & new…