Under general direction, will be responsible for the service delivery of inpatient CDI offerings. This role requires a deep understanding of acute care clinical documentation, DRG methodologies, coding guidelines, and regulatory requirements.
Essential Job Functions
Development & Execution:
Define the scope of services, target market, and competitive differentiation for our global IP CDI offerings.
Establish key performance indicators (KPIs) and metrics to measure the success and impact of the global CDI division.
Operational Leadership & Team Building:
Lead the recruitment, onboarding, training, and development of a high-performing CDI team, including CDI specialists, and potentially coding professionals across the US, India, and the Philippines.
Establish clear roles, responsibilities, and performance expectations for team members in different locations.
Implement effective communication strategies and collaboration tools to foster a cohesive and productive global team environment.
Provide ongoing coaching, mentorship, and performance management to team members.
Service Delivery & Quality Assurance:
Define and implement best-practice CDI workflows and processes for inpatient/acute care settings, focusing on DRG reviews and accurate reimbursement.
Ensure compliance with all relevant coding guidelines, regulatory requirements, and client-specific protocols.
Develop and implement robust quality assurance programs to monitor the accuracy and effectiveness of CDI reviews.
Collaborate with technology teams to identify and implement CDI software and tools to enhance efficiency and effectiveness.
Client Relationship Management:
Serve as a subject matter expert and point of escalation for client-related CDI inquiries and concerns.
Build and maintain strong relationships with key client stakeholders, understanding their specific needs and challenges.
Establish and customize key performance indicators (KPIs) and metrics to measure the success and impact of the CDI solution for each client.
Participate in client presentations and business development activities as needed.
Work closely with the sales and account management teams to support the growth of the CDI division.
Financial Performance & Reporting:
Manage the budget and financial performance of assigned CDI clients, ensuring profitability and cost-effectiveness.
Develop and analyze reports on key performance indicators, providing insights and recommendations for improvement.
Monitor industry trends and changes in reimbursement methodologies to proactively adapt CDI strategies.
Key Success Indicators/Attributes
Ability to prioritize and multi-task in a fast paced, changing environment.
Demonstrate strong organizational skills and be detail oriented.
Ability to self-motivate and self-direct.
Ability to achieve set goals and deadlines.
Demonstrate strong time management skills.
Demonstrate excellent leadership, mentoring, and interpersonal skills.
Demonstrate the ability to analyze and problem solve.
Demonstrate strong commitment to team environment.
Proficient handling difficult situations and human relations issues with professionalism and respect.
Ability to maintain professionalism when interacting with internal and external customers.
Proficient personal computer skills with MS Office (Word, Excel, Power Point, Outlook).
Excellent communication, interpersonal, and presentation skills, with the ability to effectively interact with physicians, hospital staff, and clients.
Supervisory Responsibility
Yes.
Work Environment
This job operates in a remote home office environment. This role routinely uses standard office equipment such as computers and phones.
Physical Demands
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job.
While performing the duties of this job, the employee is occasionally required to stand; walk; sit; use hands to finger, handle, or feel objects, tools, or controls; reach with hands and arms; climb stairs; balance; stoop, kneel, crouch or crawl; and talk or hear. The employee must occasionally lift or move up to 25 pounds. Specific vision abilities required by the job include close vision, distance vision, peripheral vision, depth perception and the ability to adjust focus.
Position Type/Expected Hours of Work
This is a full-time position. Days and hours of work are generally Monday through Friday, 8:00 a.m. to 5 p.m. This position occasionally requires long hours and weekend work.
Travel
Travel required; up to 20%
Required Education and Experience
Bachelor's Degree in Nursing
A minimum of 5 years' experience in leading and managing remote and international/global CDI teams.
AHIMA Certification (RHIA, RHIT or CCS)
Professional certification in CDI (e.g. CCDS or CDIP)
A minimum of 8 years' of progressive experience in Clinical Document Improvement within the inpatient/acute care setting.
Extensive knowledge of DRG methodologies (MS & APR), ICD-10 coding guidelines, and payer regulations.
Proven ability to develop and implement successful CDI strategies and initiatives that result in measurable improvements in documentation accuracy and reimbursement.
Strong understanding of clinical workflows, medical terminology, and healthcare documentation requirements.
Proficiency in using CDI software and technology solutions.
Preferred Education and Experience
Master's degree in a relevant field.
Experience in a revenue cycle management company or consulting environment.
Experience with performance improvement methodologies (e.g. Lean, Six Sigma).
Additional Eligibility Qualifications
None required
Other Duties
Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities and activities may change at any time with or without notice. Employees may perform other duties as assigned.
Founded in 2003, Omega Healthcare Management Services (Omega Healthcare) empowers healthcare to thrive via intelligent solutions that optimize revenue cycle operations, administrative workflows, care coordination, and clinical research on a global scale. The company works with providers, payers, life science companies, medical device manufacturers, health technology firms, researchers, and industry partners to amplify teams with robust technology, specialty expertise, and operational support. Omega Healthcare serves more than 350 healthcare organizations with 35,000 skilled workers in the United States, India, Colombia, and the Philippines. For more information, visit www.omegahms.com
We offer a comprehensive benefits package that may include health, dental, and vision coverage, voluntary insurance options, a 401(k) plan with employer match, professional development opportunities, paid time off, and holiday pay. Eligible employees may also have the opportunity to participate in bonus programs, commissions, or other variable incentive plans. Benefits and incentive eligibility may vary based on position, location, and tenure.
AAP/EEO Statement
Omega Healthcare is an Equal Employment Opportunity employer. All qualified applicants will receive consideration for employment without regard to their race, color, religion, national origin, gender, age, sexual orientation, gender identity or expression, marital status, mental or physical disability, protected veteran status, and genetic information, or any other basis protected by applicable law. Omega Healthcare also prohibits harassment of applicants or employees based on any of these protected categories.
Omega Healthcare makes reasonable accommodations when needed for applicants and candidates with disabilities or religious observances. If reasonable accommodation is needed to participate in the job application, interview, or any other part of the hiring process, please contact Human Resources at employeerelationsus@omegahms.com.
This position is responsible for providing day to day work assignments and support to the Clinical Documentation Integrity staff under the guidance of the Manager, Clinical Documentation Integrity. This position mentors and supports current and new staff on policies, processes, and serves as a subject matter expert on Clinical Documentation Improvement software implemented at UnityPoint Health. This position is responsible for utilizing resources to assist in staff development, audits, and competencies in order to ascertain educational needs to promote competent practice for the Clinical Documentation Integrity Specialists.
Operational Support
Provides daily work assignments, direction and workload balancing for CDS staff.
Evaluates case reconciliation data in Clinical Documentation Improvement software and perform data collection and reporting, as needed.
Performs initial and concurrent reviews in Clinical Documentation Integrity software and enters necessary documentation into the software
Subject Matter Expertise
Serves as subject matter expert for Clinical Documentation Integrity (CDI) practice, coding and software use.
Provides daily support to CDS employees for resolution of questions and/or complex issues.
Identifies issues and escalates appropriately to leadership.
Serves as primary resource for training of new and existing CDS employees.
Participates in vendor provided and other educational programs and in-services to ensure current knowledge and skills.
Education
BSN
Experience
Required
Five (5) years clinical experience in acute care, intermediate care or home care required.
Four (4) years of successful Clinical Documentation Integrity experience in the CDS role
Five (5) years leadership experience
Two (2) Years Epic
Preferred Experience
Utilization review, case management, and/or coding knowledge or experience preferred.
Experience as a clinical educator preferred.
Management experience a plus.
License/Certifications
Registered Nurse licensure
Certified Clinical Documentation Specialist (CCDS) or Certified Documentation Improvement Practitioner (CDIP)