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Job Details

Clinical Documentation Excellence Manager (Surgical Service Lines)

Requisition #: 180912
Location: Johns Hopkins Hospital/Johns Hopkins Health System, Columbia, MD 21044
Category: Non-Clinical Professional
Work Shift: Day Shift
Work Week: Full Time (40 hours)
Weekend Work Required: No
Date Posted: June 10, 2019

Johns Hopkins Health System employs more than 20,000 people annually. Upon joining Johns Hopkins Health System, you become part of a diverse organization dedicated to its patients, their families, and the community we serve, as well as to our employees. Career opportunities are available in academic and community hospital settings, home care services, physician practices, international affiliate locations and in the health insurance industry. If you share in our vision, mission and values and also have exceptional customer service and technical skills, we invite you to join those who are leaders and innovators in the healthcare field.

Position Summary:

The JHHS Clinical Documentation Excellence (CDE) Manager (Surgical Service Lines) is responsible for the oversight of the JHH, JHBMC, HCGH, SBH, and SMH Clinical Documentation Excellence surgical service lines that will be comprised of over 15 Registered Nurses (RN) and/or Health Information Professionals. This role reports to the JHHS Clinical Documentation Excellence Director and works in collaboration with the JHHS Clinical Documentation Excellence Manager (Medical Service Lines) and JHHS CDE Educator. This role identifies opportunities to improve surgical clinical documentation quality thru process review, performance/quality, and productivity reporting, and works with VPMAs, Directors, and others to implement improved process and enhancements. The manager acts as a systems expert on matters related to physician clinical documentation, coding, and reimbursement processes in working towards agreed upon quality and productivity targets for all services in the health system. Works in collaboration with finance and quality staff along with leadership team and system hospital staff to support workflow and requirements that meet reporting, coverage, and quality review requirements. Works in collaboration with Clinicians, Quality Improvement/Assurance, JHHS HIM Coding, EPIC, data teams, 3M support teams, etc.

Competencies:

Education:

Requires successful completion of an accredited program:

a) requires Baccalaureate degree from an accredited School of Nursing, OR

b) requires successful completion of an AMA approved Physician Assistant program, OR

c) requires successful completion of the academic requirements or Health Information Technician - RHIT or Registered Health Information Administrator - RHIA certification accredited by the Commission on Accreditation for Health Informatics and Information Management Education (CAHIIM).

Master’s degree preferred.

Knowledge:

  • Requires comprehensive knowledge of anatomy, physiology, as defined by the Medical Diagnostic Categories and all body systems
  • Strong background knowledge of disease process, pharmacology, and surgical techniques
  • Requires college-level knowledge of Medical Terminology
  • Requires a complete understanding of the unique functions of each clinical area
  • Requires high level knowledge of ICD-10-CM, HCPCS, MHAC, AHRQ, APRDRG, DRG and other related classification systems as demonstrated by experience using such systems
  • Requires strong understanding of HSCRC and CMI impact on hospital budget
  • Requires knowledge of GBR, HSCRC and Medicare regulations, health care data infrastructure, and hospital organization.
  • Requires experience in developing and presenting information to leadership level audiences, and coordination of staff in providing support services to clients in decentralized or consulting environments
  • Work with finance department on continuous case mix modeling and assessment
  • Track trends in documentation concerns and implementing corrective action
  • Direct coding activities to ensure accurate, consistent and compliant coding for all services
  • Create and update documentation tools on an ongoing basis
  • Provide feedback to clinical documentation specialists, case managers, coders, physicians and other clinicians involved in the documentation improvement effort
  • Recommend and implement corrective actions when deficiencies are identified
  • Requires knowledge of clinical coding processing and documentation standards, guidelines, policies and procedures
  • High level of proficiency in adult education and training
  • Requires a understanding of Hospital bylaws and Joint Commission standards related to departmental activities
  • Requires knowledge of clinical pertinence requirements and proficiency in abstraction and data entry into all of the data base systems used for clinical documentation
  • Must be able to read and interpret electronic and manual documentation generated by healthcare professionals
  • Must be proficient with the understanding of work flow in hospital facility coding
  • Knowledge of Maryland Specific Quality measures required

Skills:

  • Ability to provide leadership and direction to CDE Staff in collaboration with CDE leadership team members
  • Experience with 3M HIS products preferred
  • Ability to analyze healthcare data required
  • Robust interpersonal, communication (verbal, non-verbal, and listening) skills. Experience in developing and presenting education programs
  • An understanding of adult learning theory and instructional design.
  • Requires analytical ability in order to complete tasks assigned, gather and interpret data from different courses, and resolve problems
  • Must be able to read and understand coding guidelines. Must be able to maintain patient confidentiality
  • Strong interpersonal and communication skills are required as is knowledge of available information resources and tools
  • Independent and professional judgment is required to design and develop innovative workflow techniques structure and strategies regarding quality improvement for the health system
  • Ability to productively interact with all areas of the health system to ensure maximum revenue generation
  • Ability to successfully manage, recruit, and develop a strong team to support the revenue and regulatory initiatives of JHHS
  • Must be proficient with Outlook, Microsoft Word, Excel , and Power Point
  • Comprehensive experience with Epic and Tableau preferred

Required Licensure Certification, etc.

  1. RN: Must possess current licensure to practice as RN in State of Maryland or another state that participates in the Nurse Licensure Compact.

PA: Must possess current licensure to practice as a PA by the Maryland Board of Physicians. Board certified by the National Commission on Certification of Physician Assistants (NCCPA).

RHIT/RHIA: Must possess clinical documentation certification through the Association of Clinical Documentation Improvement Specialists (ACDIS) and/or American Health Information Management Association (AHIMA) and be a Certified Coding Specialist (CCS).

  1. Certified Clinical Documentation Specialist (CCDS) obtained through the Association of Clinical Documentation Improvement Specialists (ACDIS) and/or Certified Documentation Improvement Practitioner (CDIP) obtained through the American Health Information Management Association (AHIMA).

Work Experience:

6 years of experience in the field of quality improvement, medical record/health information administration, acute care, clinical documentation and/or coding preferred. 1 year of staff management experience required at minimum if past experience is complemented by experience in inpatient, outpatient, compliance, medical necessity, charge master coding quality improvement, or surgical clinical documentation improvement.

  • 4 years in clinical documentation strongly preferred
  • Be familiar with all government health care reimbursement systems
  • Familiarity with Quality Programs
  • Coding experience preferred

Machines, Tools, Equipment:

Must be able to operate general office equipment including a personal computer.

Requires proficiency in abstracting and data entry into all data bases used for clinical documentation.

Effectively uses Encoder to properly group diagnoses.

Grade: ML

Johns Hopkins Health System and its affiliates are drug-free workplace employers.

Johns Hopkins Health System and its affiliates are an Equal Opportunity / Affirmative Action employers. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity and expression, age, national origin, mental or physical disability, genetic information, veteran status, or any other status protected by federal, state, or local law.

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