Reporting to the Senior Vice President of Financial Operations, the Senior Director of Health Information Management (“HIM”) will be a highly analytical and process-driven leader with a solid understanding of HIM processes, coding compliance, revenue cycle and adherence to regulatory requirements. In this role you will be responsible for the strategic direction, leadership and operational oversight of the HIM department.
Collaborating with core stakeholders across the continuum, you will build relationships with Quality Management, Corporate Compliance, Informational Technology, Medical Staff, Patient Financial Services and Senior Leadership to ensure optimal compliance of coding and revenue cycle processes, and maintenance of national standards – to deliver the highest level of accuracy and efficiency.
The qualified candidate will be an experienced HIM leader with demonstrated knowledge and ability to manage, engage and mentor a team of HIM professionals and support staff in the delivery of sound and effective practices with regard to chart completion, assembly and analysis, transcription, release of information, coding, and bidirectional interfacing with CDI.
RESPONSIBILITIES: The specific responsibilities include, but are not limited to:
- Lead and manage the compliant capture-charge process, ensuring that all inpatient and outpatient accounts are coded accurately and on a timely basis.
- Establish best practices and lead continuous improvement that ensures systems and workflows achieve the highest level of accuracy and productivity.
- Collaborate with Revenue Cycle and Quality Management Departments to ensure accurate coding on all cases.
- Collaborate with the Finance Department to resolve issues related to Epic revenue-cycle workflows and work queues.
- Monitor the case-mix budget and provide detailed analyses on any variances.
- Participate in the development of health-information management policies for all operational areas, especially those related to coding.
- Ensure staff compliance with documented and established workflow guidelines and procedures.
- Work closely with Denial Management to effectively respond to DRG downgrades and other reimbursement challenges.
- Conduct formal coder training and education.
- Develop a key metric-management dashboard to report on coding performance.
- Establish strong working relationships with financial leadership and colleagues and key personnel of interfacing departments.
- Lead, mentor, and engage a staff of 30 FTE’s
- Manage resources, work assignments, and deliverables within agreed-upon scope, budget, and timeline.
- Collaborate with Information Technology leadership in developing technology strategies and maximizing functionality of systems and reporting.
- RHIA required
- Bachelor’s degreerequired; Master’s strongly preferred
- Current CCS certifications as well as 3M coding software expertise required
- Epic certification in HIM (or other Epic applications in revenue cycle) preferred
EXPERIENCE, COMPETENCIES, AND ATTRIBUTES:
- Minimum of 5-7 years of progressive hospital-based HIM leadership; previous healthcare consulting experience will be considered; previous Coding Manager/HIM experience in a major teaching/surgical setting preferred
- Strong clinical background related to coding and assignment of CCs and MCCs required
- Experience working with Clinical Documentation Improvement (“CDI”) required
- Fluency with National Coding Guidelines, AHA Coding Clinic, and ICD-10 required
- Outstanding communication skills – written, verbal and presentation
- Knowledge and ability to present and teach coding and related subjects
- Experience writing appeals related to DRG downgrades and developing dashboards/reporting tools.
- Technology and data savvy; proficiency in 3M software and Microsoft Office.