Manager, Enterprise CDI-Inpatient (Clinical Denials) at WVU Medicine

Role Overview

The Manager, Enterprise CDI-Inpatient (Clinical Denials) plays a pivotal role in ensuring the accuracy and completeness of clinical documentation within WVU Medicine's inpatient settings. This remote position is responsible for the planning, direction, and management of the Clinical Documentation Improvement (CDI) Department. The manager will lead a team of CDI specialists, hospital coding specialists, and potentially others, focusing on optimizing documentation, reducing clinical denials, and improving the overall quality of patient care. This role involves data analysis, auditing, education, and collaboration with physicians and other healthcare professionals to ensure compliance with coding and billing regulations.

Day in the Life

A typical day for the Manager, Enterprise CDI-Inpatient (Clinical Denials) might include:

• Team Management: Supervising and mentoring CDI specialists, coding specialists, and other team members. Conducting performance reviews, providing feedback, and fostering professional development.
• Data Analysis: Reviewing monthly CDI statistics to identify trends, areas for improvement, and potential coding or documentation issues. Analyzing data from monitoring and advisory agencies like ACDIS and AHIMA.
• Auditing: Overseeing quarterly CDI audits to ensure the accuracy and compliance of clinical documentation. Developing and managing audit tools to monitor the effectiveness of the CDI program.
• Education and Training: Developing and delivering educational programs for physicians, nurses, coders, and other healthcare professionals on coding and documentation guidelines. Providing ongoing training on coding and DRG updates.
• Denials Management: Analyzing clinical denials to identify root causes and implement strategies to prevent future denials. Working with the revenue cycle team to appeal denials and recover revenue.
• Compliance: Ensuring compliance with CMS, Joint Commission, and other regulatory requirements. Staying up-to-date on changes in coding and billing regulations.
• Project Management: Leading and managing CDI-related projects, such as implementing new technologies or improving documentation workflows.
• Collaboration: Collaborating with physicians, nurses, coders, and other healthcare professionals to improve clinical documentation and reduce denials.
• Reporting: Preparing and distributing physician scorecard reports. Communicating program progress to the Director at standing meetings.

Why Remote?

This remote position offers several benefits, including:

• Flexibility: Work from the comfort of your home, allowing for a better work-life balance.
• Expanded Opportunities: The remote nature of the role allows WVU Medicine to attract top talent from across the country.
• Cost Savings: Reduced commuting costs and time.
• Productivity: Studies have shown that remote workers can be more productive due to fewer distractions and a more comfortable work environment.
• Access to WVU Medicine: Be a part of one of the top healthcare systems in the nation from anywhere in the US.

Career Path

The Manager, Enterprise CDI-Inpatient (Clinical Denials) position offers several opportunities for career advancement within WVU Medicine. Potential career paths include:

• Director of Clinical Documentation Improvement: Overseeing all aspects of the CDI program for the entire WVU Medicine system.
• Senior Manager of Revenue Cycle: Taking on broader responsibilities within the revenue cycle department, such as denials management, coding, and billing.
• Compliance Officer: Ensuring compliance with all applicable laws and regulations.
• Project Manager: Leading large-scale healthcare IT or operational improvement projects.

Salary & Benefits

The estimated salary range for this position is $85,000 to $130,000 per year, depending on experience and qualifications. WVU Medicine offers a comprehensive benefits package, including:

• Comprehensive health insurance (medical, dental, vision)
• Paid time off (PTO) and vacation days
• Paid holidays
• Retirement plan with employer matching
• Life insurance
• Disability insurance (short-term and long-term)
• Flexible spending accounts (FSA) or health savings accounts (HSA)
• Employee assistance program (EAP)
• Wellness programs
• Tuition reimbursement or assistance
• Professional development opportunities
• Employee discounts

WVU Medicine Culture

WVU Medicine is a leading healthcare system in West Virginia, committed to providing high-quality patient care. The organization values teamwork, innovation, and continuous improvement. WVU Medicine fosters a supportive and collaborative work environment where employees are encouraged to grow and develop their skills.

How to Apply

To apply for the Manager, Enterprise CDI-Inpatient (Clinical Denials) position, please click the "Apply" button at the top of this page and complete the online application.

FAQ

1. What are the required qualifications for this position?

   The minimum qualifications include a Bachelor's Degree in Health Information Management (RHIA eligible/certified) or Nursing (RN or LPN credential), or an Associate Degree in Health Information Technology (RHIT eligible/certified). You must also obtain a Certified Clinical Documentation Practitioner (CDIP) or Certified Clinical Documentation Specialist (CCDS) certification within one year of hire, have two years of clinical documentation improvement experience, and two years of supervisory experience.

2. What is the salary range for this position?

   The estimated salary range is $85,000 to $130,000 per year, depending on experience and qualifications.

3. What are the benefits offered by WVU Medicine?

   WVU Medicine offers a comprehensive benefits package, including health insurance, paid time off, retirement plan, life insurance, disability insurance, and more.

4. Is this a remote position?

   Yes, this is a remote position.

5. What are the key responsibilities of this role?

   Key responsibilities include managing the CDI program, providing guidance on coding and DRG assignment, overseeing education and training, conducting audits, managing clinical denials, and ensuring compliance with regulations.

6. What is the work environment like at WVU Medicine?

   WVU Medicine fosters a supportive and collaborative work environment where employees are encouraged to grow and develop their skills.

7. What opportunities for career advancement are available?

   Potential career paths include Director of Clinical Documentation Improvement, Senior Manager of Revenue Cycle, Compliance Officer, and Project Manager.

8. How can I apply for this position?

   To apply, please click the "Apply" button at the top of this page and complete the online application.

9. What kind of experience should I have to be successful in this role?

   Successful candidates will have a strong background in clinical documentation improvement, coding, and auditing. Supervisory experience and familiarity with healthcare regulations are also essential.

10. Does WVU Medicine offer tuition reimbursement?

    Yes, WVU Medicine offers tuition reimbursement to support employees' professional development.