RN - Clinical Documentation Integrity Supervisor Job Listing at Kaiser Permanente in Wailuku, HI (Job ID 3295054-2024-04-28)

Description

Job Summary:

Supervises the Clinical Documentation Integrity (CDI) program, identifying areas of focus for improvement opportunity through report analysis interpretation of process and operational reports, financial and compliance reports, and quality rating reports. Assists with various associated operational matters including appropriate scheduling and coverage of reviews, query development and auditing, educating physicians, monitoring the program, and refining the process as needed to clarify documentation in records. Coordinates follow-up on unanswered queries during the patient stay, as needed to obtain prompt response to open queries. Works collaboratively with the CDI team to facilitate documentation with physician, case manager, utilization reviewer, nurse or other healthcare professionals, utilizing appropriate querying tools to capture needed documentation.

Essential Responsibilities:

• Supervises individual(s) including but not limited to: hires, trains, assigns work, manages and evaluates performance, conducts professional development plans. Ensures that the productivity and actions of that group meet/support the overall operational goals of the department as established by department leadership.
• Works region-wide to implement and monitor departmental policies and procedures that support organizational goals, business objectives and Clinical Documentation accuracy and data quality.
• Performs periodic queries in a production context to provide feedback and expertise on areas of opportunity as it relates to the department workflow.
• Represents the department at all required Clinical Documentation meetings with external stakeholders as needed.
• Oversight of day to day operations of assigned CDISC team members to include, but not limited to timekeeping, performance reviews, CDI workflow enhancements based on quality audits, root cause analysis on performance variability to establish best practices, and Physician champion outreach.
• Maintains limited daily assignment for clinical reviews.
• Develops recommendations as required to documentation templates; scorecards, physician queries based on coding and documentation changes, regulatory modifications and quality review findings.
• Responds to documentation inquiries from other Maui Health departments including but not limited to Quality and Core metrics, and Patient Safety.. Reviews and reports on monthly scorecards.
• Facilitates compliance with regulatory documentation / coding requirements and improves the quality of health information data.
• Provides clinical content expertise to HIM coders as required.
• Establishes effective working relationships with HIM directors, providers, physician reviewers and HIM data quality managers.
• Conducts data analysis and clinical research as required.
• NOTE: Travel may be required.

Basic Qualifications:

Experience

• Minimum three (3) years of work experience in clinical nursing, Healthcare Consulting, Operations or Project management, in a health care setting.
• Minimum two (2) years of experience in health information management or clinical documentation.
• Minimum one (1) year of management, supervisory or leadership* experience.

Education

• Bachelors degree in nursing, business administration, health care, public health, finance, business health information management) OR four (4) years of experience in a directly related field.
• High School Diploma or General Education Development (GED) required.

License, Certification, Registration

• Registered Nurse License (Hawaii) required at hire
• Documentation Improvement Practitioner Certificate

Additional Requirements:

• *Leadership experience will be permissible for Kaiser Permanente internal applicants only and is defined by the following criteria: Demonstrated clinical nursing leadership as a Charge/Senior RN, participation on professional committees inclusive of UBTs, National Certification in Specialty, and/or demonstrated experiential exposure to Nursing Leadership.
• Demonstrate ability to understand, utilize and apply the methods, principles, practices and techniques related to coding of health information data.
• Working knowledge of MS-DRGS and HCCs including, but not limited to, International Classification of Diseases Clinical Modification (ICD-CM)
• Demonstrate ability to interact with diverse groups at all levels of the organization and must have excellent communication & presentation skills (written and verbal).
• Demonstrate ability to work in a team environment, build effective teams &motivated self-starter.
• Demonstrate ability to respond to detailed clinical documentation questions from Hospital HIM coders, nurses or physicians; reviews analytical data and monitor clinical documentation scorecards and communicates training needs to external stakeholders as required.
• Demonstrate experience with results-oriented approach.
• Must excel in a collaborative and consensus building environment.

Preferred Qualifications:

• Management and clinical experience.
• Previous nursing management experience in an acute care setting and/or management consulting experience preferred.
• Previous EPIC or electronic health record (EHR) experience preferred.
• Successful completion of a professional American Health Information Management Association (AHIMA) or American Academy of Professional Coders (AAPC) sponsored/recognized coding course
• Certified Professional Coder (CPC), Certified Professional Coder-Physician (CPC-P), or Certified Professional Coder-Hospital (CPC-H) by the American Academy of Professional Coders (AAPC)
• Masters degree preferred.