Cleveland Clinic Manager-HIMS-Quality-CDI in Abu Dhabi, United Arab Emirates
The Manager, HIMS Quality & CDI is responsible for managing and supporting the activities and functions of the HIMS clinical documentation improvement to ensure departmental and administrative goals related to optimal and compliant reporting of clinical coding data for reimbursement and regulatory reporting are met. These functions are performed in accordance with all applicable laws and regulations of the UAE and CCAD"s mission, vision, policies and procedures.
PRIMARY DUTIES AND RESPONSIBILITIES
Supervises and manages daily operations of the Clinical Documentation Improvement (CDI) and clinical coding audit teams.
Ensures compliant, accurate, coding through implementation of policies, procedures, and workflows within the CDI and Clinical Coding Audit teams.
Implements and coordinates all activities within the scope of the HIMS Clinical Coding Auditing program to ensure compliance to regulatory requirements for clinical coding.
Collaborates in education of Clinical Operations regarding specific documentation needs for appropriate reimbursement identified through concurrent and retrospective documentation reviews and clinical coding audits.
Develops and recommends new or revised training goals and objectives to the HIMS and RCM Management teams based on trends in clinical coding and documentation.
Prepares reports on HIMS CDI activities including trend analysis, Key Performance Indicators (KPIs), or other ad hoc reports for management or external agencies.
Evaluates CDI effectiveness to develop improved methods; devises and implements evaluation methodology for CDI and clinical coding audits; analyzes results and recommends and/or takes appropriate action.
Reviews regulatory and clinical coding best practices independently or in conjunction with the HIMS Management team to ensure that clinical coding and clinical documentation is compliant.
Performs IR-DRG reviews with the Physician Liaison and provides feedback on review results to the Clinical Coding Manager and Coding Technicians.
Manages the development of pertinent communications regarding clinical documentation and clinical coding for distribution such as newsletters, brochures or flyers; coordinates process from development through printing and distribution.
Develops and facilitates workshops, meetings or conferences on documentation improvement and coordinates logistics, and scheduling related communications.
Creates or revises training courses within the Learning Management System (LMS) when any new or revised policy, procedure, or workflow is released.
Reports to and collaborates with Clinical Operations and Medical Informatics on clinical documentation improvement initiatives and present clinical coding trends for review with physicians and hospital leadership.
Participates in internal education programs for Clinical Operations regarding regulatory requirements and guidelines for clinical documentation and clinical coding.
Works with the EMR IT team to troubleshoot issues related to clinical documentation workflow.
Oversees the implementation and utilization of the Computer Assisted Coding (CAC) software.
Maintains confidentiality of the patient"s confidential health information (CHI) in both electronic and paper formats.
Performs other duties and participates in special projects as assigned by the HIMS Management team.
Minimum 3 years experience in a Health Information Management (HIMS) or Revenue Cycle Management (RCM) Department preferred. Minimum 3 years experience utilizing the ICD-9-CM or ICD-10 coding preferred Minimum 1 years experience utilizing the CPT 4 coding system. preferred Knowledge of on the job training techniques and mentoring principles preferred Skilled in the use of Microsoft Word, Excel, and Power Point to develop training materials, reports, and documents. Ability to work with audio and visual equipment in a classroom environment. Ability to work under pressures and deadlines. Excellent level of oral and written English.
Minimum of Associates of Science in Health Information Technology or Healthcare Management is required Bachelors in a healthcare related field or is preferred Graduate of a recognized clinical coding program preferred. Graduate of a clinical training program preferred CCA, CCS, CPC, or CCS-P preferred.