Full Job Description
Strength Through Diversity
Ground breaking science. Advancing medicine. Healing made personal.
Dept - Mount Sinai Health Partners
REQ - 2621484
Job Title: Clinical Documentation Improvement Manager
Mount Sinai is one of the largest U.S. health systems with a strong reputation for quality of care and research. We have over 38,000 employees working together to provide billions of dollars in high-quality care each year for millions of patients.
We are accelerating a transition to a business model focused on population health management – our goal is to keep entire communities healthy and out of the hospital. Mount Sinai Health Partners (MSHP) is the team driving this transformation within Mount Sinai. The team includes 400+ employees with clinical, contracting, finance, IT, analytics, operations, and product development expertise.
MSHP is a fast growing business unit within Mount Sinai and is looking for team members who:
Are comfortable “playing up” and “playing down” as needed to accomplish business objectives
Work productively amidst ambiguity
Thrive in fast-paced work environments
Seek to improve the status quo
What We Offer
Opportunity for advancement within MSHP team
Opportunity to work directly with senior leaders from across the Mount Sinai Health System and external organizations
Opportunity for mentorship from senior MSHP leaders
Opportunity to be part of a forward-thinking team driving a system-wide transformation
Opportunity to work at the forefront of innovation in healthcare
Within MSHP, the Clinical Operations Team within MSHP drives the implementation and ongoing improvement of clinical initiatives that enable Mount Sinai to deliver better value to its patients, its providers, its customers (i.e., plan sponsors and payers), and its partners. At Mount Sinai, value is defined broadly and encompasses improved health outcomes, more efficient operations, better patient experience, more joyful care team environment, and improved financial performance.
The Ambulatory CDQI team helps ensure accurate, timely, and quality clinical documentation in the medical record to reflect the health status of patients and the care they receive. CDQI specialist are responsible for retrospective reviews of electronic health records for conflicting, incomplete, or nonspecific provider documentation as it relates to appropriate HCC code capture.
The Manager, Ambulatory CDQI with oversight from the Director shall be responsible for the daily oversight of staff to meet departmental and corporate objectives to ensure that all patient charts are documented and coded to the highest specificity. This includes planning, monitoring, review and evaluation of the department policies and procedures. The Manager will be responsible for ensuring compliance with the Standard Operating Policy, adherence to milestones and timely execution of deliverables. This position will also be responsible for the review of the monthly processes and analysis, and preparation of reporting packages. They will provide direct oversight for the CDQI Specialists for day to day workflow and other management related needs. The Manager will track and trend coding and documentation issues, develop targeted provider education, and create best practices for medical record review and diagnosis code abstraction. The incumbent will work closely with all departments within Mount Sinai Population Health. The Manager will assist the Director to ensure that all governmental and compliance requirements are met.
Roles & Responsibilities:
Systematically evaluates the quality and effectiveness of the CDQI department analyzing appropriate internal and external data and information to identify opportunities for improving CDQI practices.
Provides on-going feedback to CDQI staff regarding the quantity and quality of concurrent queries. Provides suggestions as to opportunities for additional and/or more appropriate queries. Addresses CDQI staff questions. Along with Analytics, develops mechanisms for auditing quality of CDQI queries on an ongoing basis.
Develops implements and evaluates documentation and query tools with CDQI staff and medical care teams. Conducts annual review of tools content based upon changes in ICD-10 codes and revises or develops new tools as needed. Based upon audit results, provides feedback to medical teams which could enhance the accuracy of patient record documentation.
Provides status reports of the department. Maintains and interprets master CDQI report package for trends, accuracy and performance improvement.
Decisions and actions are based on ethical principles and foster a non-discriminatory climate.
Responsible for interviewing and hiring.
Responsible for operating within approved budget.
Provides leadership, direction and guidance to staff.
Coordinates and maintains the required training and skills for staff.
Implements corrective actions and conducts performance evaluations.
Effectively addresses personnel issues in order to promote a productive and healthy and positive work environment.
Performs other duties as assigned or required
Associates degree required. Bachelor’s degree preferred.
Minimum of 3-5 years senior-level, training or supervisory experience on a team that focuses on clinical documentation and/or coding required. This experience should include but is not limited to, experience with training and onboarding new team members, serving as a mentor, monitoring work product, delivering feedback, and overseeing a quality review process.
Relevant AAPC, AHIMA or ACDIS certification required i.e. CCS (Certified Coding Specialist), CPC (Certified Coding Professional), CIC (Certified Inpatient Coder) or CCDS Certified Clinical Documentation Specialist
CRC (Certified Risk Adjustment Coder) strongly preferred. Must obtain within one year.
Minimum three (3) years in a health care setting is required.
Minimum one (1) year of experience reviewing records and accurately applying ICD-10-CM diagnosis codes.
Additional Skills and Qualities:
Verifiable ability to effectively communicate on a verbal and written basis with staff, management and providers is required.
Demonstrated ability to determine, analyze and solve escalated issues related to medical record documentation and coding deficiencies required.
Ability to interpret ICD-10, CMS and HHS guidelines.
Advanced knowledge of Microsoft Office, including Word, Excel, Outlook and PowerPoint is preferred
Demonstrated ability to pro-actively identify problems, as well as recommend and/or implement effective solutions.
Demonstrated ability to identify improvement opportunities for processes and reports.
Must be detail-oriented with strong organizational skills, including the ability to coordinate workflow.
Demonstrated ability to lead, coach, train or supervise staff.
Demonstrated ability to work independently and with a team to contribute to department goals.
Excellent verbal and written communication skills
Flexibility to adapt to a changing and fast-paced environment.
Demonstrated ability to work with and maintain confidential information.
Strength Through Diversity
The Mount Sinai Health System believes that diversity and inclusion is a driver for excellence. We share a common devotion to delivering exceptional patient care. Yet we’re as diverse as the city we call home- culturally, ethically, in outlook and lifestyle. When you join us, you become a part of Mount Sinai’s unrivaled record of achievement, education and advancement as we revolutionize healthcare delivery together.
We work hard to recruit and retain the best people, and to create a welcoming, nurturing work environment where you have the opportunity and support to develop professionally. We share the belief that all employees, regardless of job title or expertise, have an impact on quality patient care.
Explore more about this opportunity and how you can help us write a new chapter in our story!
Who We Are
Over 38,000 employees strong, the mission of the Mount Sinai Health System is to provide compassionate patient care with seamless coordination and to advance medicine through unrivaled education, research, and outreach in the many diverse communities we serve.
Formed in September 2013, The Mount Sinai Health System combines the excellence of the Icahn School of Medicine at Mount Sinai with seven premier hospitals, including Mount Sinai Beth Israel, Mount Sinai Brooklyn, The Mount Sinai Hospital, Mount Sinai Queens, Mount Sinai West (formerly Mount Sinai Roosevelt), Mount Sinai St. Luke’s, and New York Eye and Ear Infirmary of Mount Sinai.
The Mount Sinai Health System is an equal opportunity employer. We comply with applicable Federal civil rights laws and does not discriminate, exclude, or treat people differently on the basis of race, color, national origin, age, religion, disability, sex, sexual orientation, gender identity, or gender expression.