Director – HIM & Clinical Doc Ex

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Job Requisition ID:

R00014310

Job Category:

Health System

Organization:

Revenue Cycle

Location/s:

Jackson Medical Mall

Job Title:

Director
– HIM & Clinical Doc Ex

Job Summary:

Position will oversee the clinical documentation excellence and improvement function in the organization in close collaboration with CMO, CIO and DIS leadership to improve metrics for public reporting, provider documentation, and financial performance.

Participates in defining and formulating clinical initiatives and projects that will enable realization of the organization’s vision in terms of developing clear business cases, value propositions, and measures of success.

Develop and implement information technology solutions in concert with the CIO and CMO.

Champions and partners with physician community on all major clinical information technology projects impacting EMR.

Coordinates with Compliance in all requirements for provider audit and education.

Oversees management of daily operations of Health Information Management for the Health system and oversee support functions of coding, charge entry, medical records, incomplete medical records, front end revenue integrity, and customer service.

Responsible for recruitment and training of new and existing staff and for evaluations of staff.

Collects, reports, and analyzes data in regard to peer group benchmarks and performance goals.

Serves as the custodian of record for university hospital and health system.

Oversees Health Information Management in Jackson, Holmes county, and Grenada hospitals and clinics.

Responsible for administering the clinical documentation improvement program at all UMMC healthcare facilities, inclusive of inpatient and outpatient clinical documentation.

These duties include performing appropriate analytics, balanced with actual payment denial data and trends, to identify appropriate areas of focus for efforts aimed at improving clinical documentation.

In addition, the selection and training of clinical documentation improvement staff, the development of monitoring and measuring tools, and the implementation and use of those tools, is an integral part of this position’s responsibility.

The position will be responsible for partnering with key physician(s) and administrators to develop action plans, priorities, and then deploy tactics in order to educate providers throughout the organization.

Education & Experience

Bachelor’s degree in Finance, Business, Health Care Administration, Health Information, Nursing or other related field and seven (7) years related Revenue Cycle experience or equivalent combination of education/experience.

Master’s degree preferred.

Seven (7) years in a relevant management level position in a complex health system or insurance environment.

Certifications, Licenses or Registration Required: 

Certified professional coder (CPC) from American Academy of Professional Coders, (AAPC) or certified coding specialist (CCA, CCS, OR CCS-p) from American Health Information Management Association (AHIMA), registered Health Information Administrator (RHIA) or registered Health Information Technician (RHIT) Certification by AHIMA.

RN or APN licensure preferred

Knowledge, Skills & Abilities

Knowledge of Medical Records content and management.

Knowledge of HIPAA Privacy and Security Rules.

Knowledge of the joint commission accreditation standards regarding medical records.

Knowledge of state laws and regulations regarding management of medical records.

Knowledge of medical terminology and clinical documentation requirements.

Must have a good working knowledge of the EHR either through experience or education, including experience working with structured data and database management.

Possess excellent written, verbal, and interpersonal communication skills.

Excellent customer service, analytical, and problem solving skills.

Organize and prioritize work.

Work effectively with rapidly changing priorities.

Articulate problems and offer solutions to resolve them.

Make decisions in the absence of a supervisor or manager.

Analyze data, problem solve, implement solutions to problems correctly, and write procedures for a variety of computer-based tasks.

Work independently or in a team setting.

Demonstrate proficiency in Microsoft office software products.

Implement continuous quality improvement strategies.

Previous experience with Electronic MPI, patient registration, and billing and clinical systems processes.

Experience with the implementation and use of an EHR system in an acute care hospital setting in the HIM setting or Information Services setting.

System table maintenance experience.

Working knowledge of APCS, DRGS, Case Mix Index, ICD-9
– and ICD-10, and CPT Coding.

Must possess a broad knowledge of clinical terminology, and must understand claim denials and how clinical terminology may impact covered services.

Must possess presentation and education skills to allow for very specific training to highly educated professionals (MD’s and APP’s).

Responsibilities

• Creates and routinely updates impact analysis of clinical documentation improvement and clinical documentation education that can be used to appropriately monitor the results of the program.
• Partners with the Quality, Information Systems, the CMO and CIO to identify areas of opportunity that will lead to improved metrics in public reporting and implementing plans to achieve the these improvements.
• Partners with Physician Advisors to support physician documentation and decision-making related to payer policies, patient status, etc.

  to avoid denial for failure to meet medical necessity and/or non-covered or unauthorized services

• Coordinates projects with clinical and financial information systems to improve the financial results from improved and compliant documentation, coding, and billing .
• Coordinates with compliance and risk in audit activities and executes plans for provider documentation improvement through CDI/CDE
• Oversees direct and coordinate the daily operations for all hospital and physician, health information management activities, ensuring that functions are aligned with the strategic goals and objectives that meet or exceeds peer group benchmarks.
• Designs and implements measures to increase productivity, maximize cash flow, attain or exceed peer group benchmarks for accounts receivable, improve customer service, contain costs, and maximize the utilization of information technology, space, and resources.

  Maintains and monitors CBO best practice billing and collection procedures to maximize cash flow.

• Serves as liaison with hospital coding, patient registration, revenue cycle, clinicians and information systems to resolve issues arising from incorrect patient data or obtaining health information from the record.

  Takes an active role in policy and procedure development for medical records to support functions throughout the UMMC system.

• Oversight for medical records functions and management within the electronic health record and legacy paper systems.

  Major functional areas include deficiency

• Analysis, transcription, release of information, records retention and archiving, scanning and indexing, and chart corrections.
• Works with physicians, clinicians, and other him professionals to support the integrity of the medical record.

  Apply HIPAA, CMS, TIC, and other regulatory and compliance guidelines as appropriate and support UMMC employees on the proper understanding and implementation of guidelines as applied to the electronic health record.

  Participate in and lead committees related to medical records functions, such as the medical forms committee and hospital accreditation, compliance, and training committees.

• Ensures that customer service practices are enacted timely with regard to inquiries or complaints.

  Performs quality checks to minimize errors in billing and insurance denials/rejections.

• Develop statistical reports related to medical staff performance including admission volumes, procedure volumes, DRG types by volume, specific monitors (H&P and Operative Report Timeliness); medical record delinquencies; medical record patterns, trends or errors in documentation; any other report identified by medical staff for monitoring performance.
• Interview, hire, coach, mentor, and train new employees.

  Monitor for and resolve disciplinary issues.

  Work with human resources to develop a competent health information management staff supporting an electronic health record.

• Administer the clinical documentation improvement service, supervising the clinical nurses responsible for reading and analyzing clinical documentation, and communicating through inquiries with practitioners.
• The duties listed are general in nature and are examples of the duties and responsibilities performed and are not meant to be construed as exclusive or all-inclusive.

  Management retains the right to add or change duties at any time.

Physical and Environmental Demands
Requires occasional working hours significantly beyond regularly scheduled hours, occasional travelling to offsite locations, occasional activities subject to significant volume changes of a seasonal/clinical nature, constant work produced subject to precise measures of quantity and quality, occasional bending, occasional lifting and carrying up to 75 pounds, occasional climbing, occasional crawling, occasional crouching/stooping, occasional driving, occasional kneeling, occasional pushing/pulling, occasional reaching, frequent sitting, frequent standing, occasional twisting, and frequent walking.

(occasional-up to 20%, frequent-from 21% to 50%, constant-51% or more)

Time Type:

Full time

FLSA Designation/Job Exempt:

Yes

Pay Class:

Salary

FTE %:

100

Work Shift:

Benefits Eligibility:

Benefits Eligible

Job Posting Date:

06/4/2021

Job Closing Date (open until filled if no date specified):

Full time

R00014310

About Us

About Us

The University of Mississippi Medical Center (UMMC), headquartered in Jackson, is the state’s only academic medical center.

Here, we work to improve the lives of Mississippians through our three missions of education, research, and health care.

Education: UMMC includes seven health science schools: medicine, nursing, dentistry, health related professions, graduate studies, population health, and pharmacy.

(The School of Pharmacy is headquartered on the University of Mississippi campus in Oxford.) Enrollment in all programs is more than 3,000 students.

Research: From world-renowned studies on heart disease, diabetes, and hypertension to advanced treatment for cancer and a human physiology simulation program used by NASA, researchers at UMMC are unraveling the diseases that affect Mississippians, while creating new, high-tech jobs and injecting tens of millions of dollars annually into the state’s economy.

Health Care: UMMC provides a wide-range of patient care programs.

At our main campus in Jackson, in addition to outpatient clinics, we offer a women and infant’s hospital and a critical care hospital along with University Hospital, plus the state’s only:

• Children’s hospital (Batson Children’s Hospital)
• Heart, kidney, liver, and pancreas transplant programs
• Adult and pediatric congenital heart programs

We also care for Mississippians statewide with community hospitals UMMC Grenada, UMMC Holmes County, plus pediatric clinics in Tupelo, Hattiesburg and the Gulf Coast.

In addition, our Center for Telehealth offers specialized care remotely, through online video chat technology, at more than two hundred locations throughout the state.

EEO Statement:

The University of Mississippi Medical Center provides equal opportunity in any employment practice, education program, or education activity to all qualified persons.

The Medical Center complies with all applicable laws regarding equal opportunity and affirmative action and does not unlawfully discriminate against any employee or applicant for employment based upon race, color, gender, sex, sexual orientation, gender identity or expression, religion, national origin, age, disability, veteran status, or genetic information.

Inquiries or complaints may be referred to the Office of the Director, Employee Relations, 2500 North State Street, Jackson, MS 39216-4505.