Join the transformative team at City of Hope , where we're changing lives and making a real difference in the fight against cancer, diabetes, and other life-threatening illnesses. City of Hope's growing national system includes its Los Angeles campus, a network of clinical care locations across Southern California, a new cancer center in Orange County, California, and treatment facilities in Atlanta, Chicago, and Phoenix. Our dedicated and compassionate employees are driven by a common mission: To deliver the cures of tomorrow to the people who need them today.
The Director of CDI and Coding has oversight and responsibility for the CDI and Coding and Data Quality functions for the system. This role will execute the strategy for the provision of CDI and coding and provide leadership and direction for the CDI and Coding teams across the system. Works with the CDI and coding management team to develop and establish policies and procedures to support compliant coding and billing for services. Establishes key metrics for inpatient, ambulatory surgery and outpatient coding processes for benchmarking purposes. Serves as a liaison between the CDI team and the medical staff. The incumbent is pivotal in leveraging their clinical knowledge and position to provide education to the CDI Staff, the medical staff, APPs, and other clinicians on matters related to proper and adequate documentation practices, improvement of clinical protocols, medical necessity and associated clinical documentation, level of care progression, and denials management. This work is done in collaboration with the Health Information Management (HIM) department leaders, the CDI Governance Committee, key stakeholders involved in the revenue cycle and payer strategies, improvement of hospital Quality measures, reduce denials and protect the integrity of the documentation within the Electronic Medical Record (EMR).
As a successful candidate, you will:
- Act as a liaison between the health information management department's clinical documentation improvement professionals and the hospital's medical staff to facilitate accurate and complete documentation for coding and abstracting of clinical data, capture of severity, acuity, and risk of mortality, in addition to DRG assignment.
- Educate physicians and APPs on documentation concepts, bridging the gap between clinical language and documentation requirements.
- Work with COH Foundation regarding HCC coding and documentation.
- Serve on various committees such as Case Management/Utilization Management, Sepsis, QA & I, Quality Improvement including Complication/PSI Coding, CDI Touch Base Committee, CDI Governance, ADCC, Medical Record Committee and Denial Management.
- Conduct clinical reviews through the query escalation process on cases referred by HIM Management and other healthcare professionals to meet regulatory requirements in accordance with the hospital objectives for assuring quality patient care and effective, efficient utilization of health care services.
- Provide clinical direction for development and implementation of chronic condition care management programs, including integration of and compliance with payor mandated procedures, coordination of referral processes, and comparison to benchmarks of all utilization data and timely reporting of same to staff and management.
- Collaborate with physician leadership in clinical departments to define clinical criteria for CDI team to use when determining whether to query or not (i.e. Dietary, Cardiology etc.).
Qualifications:
- Board Certified MD or DO with an active California license.
- 7 years of clinical experience.
- 5 years of experience in a leadership capacity.
- Clinical Documentation Improvement Training.
- MD/DO.
City of Hope is an equal opportunity employer. To learn more about our commitment to diversity, equity and inclusion, please click here .
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