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OP CDI Program Manager-RN
Overview
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We are seeking a fully remote RN Program Director, Outpatient CDI to:
- Be responsible for the leadership, direction, and subject matter expertise in Outpatient CDI and risk adjustment.
- Develop and implement outpatient CDI strategies and initiatives to improve the quality and accuracy of clinical documentation across the UW Health ambulatory care system.
- Lead and participate in systemwide Outpatient CDI, coding, and clinical risk adjustment committees.
- Partner with physician and advanced practice provider leaders and other key stakeholders on all aspects of compliant and accurate risk adjustment documentation.
Work Experience:
- 4 years of OP CDI experience, including two (2) years of progressively responsible leadership experience in OP CDI Risk adjustment (including training and provider education) Required
- 5 years of OP CDI/HCC Risk adjustment experience, including partnering with physician leadership groups. Preferred
Certifications:
- Licensed as a Registered Nurse (RN) in the State of WI or holds a license issued by a jurisdiction that has adopted the nurse licensure compact Upon Hire Required and
- Certified Clinical Documentation Specialist – Outpatient (CCDS-O) Upon Hire Required
- Certified Risk Adjustment Coder (CRC) Preferred
- Certified Professional Coder (CPC) Preferred
- Education:
- Bachelor’s Degree in Nursing Required
- Master’s Degree in Nursing Preferred
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MAJOR RESPONSIBILITIES |
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Develop and implement outpatient CDI strategies and initiatives to improve the quality and accuracy of clinical documentation across the ambulatory care system.
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Oversee the day-to-day operations cross functional leadership of the outpatient CDI and HCC coding programs
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Establish program goals, performance metrics, and continuous improvement strategies.
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Work closely with clinical leaders including physicians, nurse practitioners, and other healthcare providers to educate them on documentation best practices and the importance of accurate clinical documentation.
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Lead both nurses and coding professionals to ensure that documentation supports coding and billing practices and adheres to coding guidelines and payer requirements.
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Coordinate with other departments and stakeholders to integrate CDI practices into outpatient care workflows. Including but not limited to Clinical leadership, Population Health, Ambulatory operations, Revenue Cycle, Coding and Compliance.
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Lead development of training programs for clinical staff on documentation standards, compliance requirements, and best practices.
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Oversee ongoing education and support to ensure adherence to changes in regulations, coding guidelines, and documentation practices.
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Monitor and analyze documentation and coding practices and outcomes to identify areas for improvement.
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Lead and implement audits and reviews to assess the effectiveness of the CDI program and implement corrective actions as needed.
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Utilize data and analytics to drive quality improvement initiatives and report on program performance.
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Ensure the outpatient CDI program complies with all relevant regulations, including CMS, payer guidelines, and other industry standards.
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Stay informed about changes in healthcare regulations and documentation requirements and update the CDI program accordingly.
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Prepare and present reports on program performance, outcomes, and improvement initiatives to senior management and other stakeholders.
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Communicate effectively with clinical and administrative staff to foster a culture of compliance and documentation excellence.
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Location: Remote,
Type: Contract To Hire
Pay: Apply for details
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