Director, Clinical Documentation Integrity - Remote

Overview

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. The culture is guided by inclusion, with talented peers, comprehensive benefits and career development opportunities.

Join us to start Caring. Connecting. Growing together.

The Service Area Director, Clinical Documentation Integrity (CDI) directs the activities of the CDI department. This role provides CDI program oversight and day-to-day implementation of processes related to the concurrent review of clinical documentation in the inpatient medical records of Optum Insight Client patients at multiple hospitals. Responsibilities include planning, administration, control and quality management of CDI activities, with regular reporting to hospital leadership.

The position collaborates with providers and other healthcare team members to improve documentation quality and reflect the clinical treatment, decisions and diagnoses. It utilizes clinical expertise and CDI best practices to align with Optum's mission, standards and values. The CDI Director does not perform patient care duties or have direct patient interactions.

The CDI Director leads multi-site CDI programs across hospital systems in Pennsylvania, Massachusetts and New York. It is a high-impact leadership role responsible for program performance, partnering with hospital executives, and distributing leadership across multiple facilities. The role involves education of all phases of the CDI process across a service area and ongoing CDI education for physicians and staff. Tracks and trends program compliance to identify educational opportunities.

• 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

• 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 KPIs
• Direct and maintain adequate staffing and workflow to meet CDI needs
• Monitor reports and productivity to ensure production standards and objectives
• Lead the CDI program and monitor KPIs, communicating with facility leadership and implementing process changes
• Engage with Physician Advisor and/or CMO to resolve provider issues
• Serve as a resource to Physicians / Case Managers and other staff on clinical documentation improvement and ICD-10
• Collaborate with medical records, quality, finance and physician groups to facilitate complete documentation for data reporting
• Develop and monitor strategic operating goals, budgets and performance
• Develops and manages direct and indirect reports
• Build productive inter/intra-departmental and vendor relationships to optimize operations
• Ensure compliance with government and agency regulations
• Provide ongoing CDI education for providers and staff; track and trend program compliance
• Interact with hospital leadership, clinical teams, Quality, Care Coordination and other departments across multiple facilities and client accounts
• Manage multiple projects, cross-functional teams, and strategic initiatives

• Design and implement education programs for CDI staff
• Develop and conduct ongoing CDI education for new staff
• Participate in ongoing education of staff

• Communicate information effectively
• Monthly reporting of CDI program progress to hospital leadership
• Respond to questions and requests promptly
• Serve as a resource regarding policies and procedures

• Required:
  
  RN, MD/ DO or FMG
• CCD/ CDIP certification
• 4+ years CDI…