• Job Description

  Req#: R20825

  Job Category:

  Revenue Cycle

  Work Shift/Schedule:

  8 Hr Morning - Afternoon

  Northeast Georgia Health System is rooted in a foundation of improving the health of our communities.

  About the Role:

  Job Summary

  The Manager of Clinical Documentation Improvement (CDI) is responsible for managing the day to day operations of the Clinical Documentation Improvement (CDI) department at Northeast Georgia Medical Center. This position plays a critical role in ensuring documentation accuracy, optimizing reimbursement, minimizing denials, improving case mix index (CMI), and ensuring appropriate utilization of hospital resources. The Manager works closely with the Director of UM/CDI, Physician Advisor(s), data analyst, educator, and compliance to enhance quality reporting, patient outcomes, and financial integrity.

  Minimum Job Qualifications

  • Licensure or other certifications: Current Registered Nurse license in the State of Georgia. CDI certification (CDIP, ACDIS, AHIMA)

  • Educational Requirements: Bachelor's Degree in Nursing

  • Minimum Experience: Minimum of five (5) years in Clinical Documentation Improvement, 1+ year of progressive leadership experience.

  • Other:

  Preferred Job Qualifications

  • Preferred Licensure or other certifications:

  • Preferred Educational Requirements: Master's Degree in Nursing or other health related field

  • Preferred Experience:

  • Other:

  Job Specific and Unique Knowledge, Skills and Abilities

  • Proven ability to lead teams, manage budgets, and implement strategic initiatives.

  • Strong ability to educate and influence physicians, staff, and leadership on CDI.

  • Experience in data analysis, KPI tracking, and performance improvement strategies.

  • Expertise in coding and DRG reimbursement, case mix index (CMI) optimization, payer regulations, and revenue cycle principles.

  Essential Tasks and Responsibilities

  • Manage the daily operations of the CDI department to include daily huddles, staff assignments, work queues and timely communication. Provides routine updates to Director and escalates as appropriate.

  • Manages productivity and staffing to ensure financial stewardship and resource allocation. Assesses and manages departmental workload to determine appropriate staff allocations to ensure productivity standards are consistently met.

  • Review daily, weekly and monthly reports to monitor and analyze performance of department, assess data against KPI standards and goals, and identifies trends. Makes adjustments where needed. Keeps leadership, staff, and clinical staff (where appropriate) informed.

  • Performs regular audits of CDI chart reviews and drafted queries to ensure appropriate, compliant query usage, as well as effective

  • identification of all query opportunities.

  • Actively participates in the recruitment, training, and management of high-performing CDI professionals; ensuring operational alignment with hospital objectives.

  • Actively participates in chart review process as needed and indicated by productivity

  • Assists in the development and implementation of performance metrics to evaluate team effectiveness and drive continuous improvement.

  • Foster a strong relationships with internal and external stakeholders, including interdisciplinary team members, physicians, and payers.

  • Provide data-driven insights and strategic recommendations to leadership regarding CDI.

  • Works with the CDI team utilizing hospital coding policies and procedures, Federal and State coding reimbursement guidelines, application of Coding Clinic Guidelines to assign working DRG, reviewing patient record throughout the hospitalization to ensure codes are reported at the highest level of specificity.

  • Work closely with the Director and Physician Advisors to develop and revise policies and procedures related to denials and appeals

  • Provides education to operational leaders, staff and Physicians on the importance of the Clinical Documentation Improvement Program (CDIP), and works cooperatively with them to ensure that improved documentation is seen as part of the strategic mission of the Organization

  • Facilitates modifications to clinical documentation through extensive concurrent interactions with Physicians, nursing staff, case managers, and coding team to ensure that appropriate reimbursement and severity of illness (SOI) is captured.

  • Collaborates with the educator, Director and Physician Advisor Develops for the ongoing continuing education plan for the CDI team to maintain an up-to-date knowledge of CDI related guidelines

  • Ensures that provider documentation provides an accurate reflection of severity of illness and that appropriate diagnoses

  • are rendered with adequate specificity, by concurrently reviewing inpatient record and addressing opportunities with physicians verbally or via other electronic forms of communication

  • Ensures interaction with the Physicians/AHPs when there is missing, ambiguous, or conflicting information in the medical record by requesting additional documentation for correct coding and compliance necessary for an accurate reflection of the case mix index (CMI), length of stay (LOS), and optimal resource utilization.

  • Works closely with physicians and staff to provide and monitor clinical/financial data for the purpose of improving hospital/physician performance and anticipating payer and managed care demands.

  Physical Demands

  • Weight Lifted: Up to 20 lbs, Occasionally 0-30% of time

  • Weight Carried: Up to 20 lbs, Occasionally 0-30% of time

  • Vision: Moderate, Frequently 31-65% of time

  • Kneeling/Stooping/Bending: Occasionally 0-30%

  • Standing/Walking: Occasionally 0-30%

  • Pushing/Pulling: Occasionally 0-30%

  • Intensity of Work: Frequently 31-65% of time

  • Job Requires: Reading, Writing, Reasoning, Talking, Keyboarding, Driving

  Working at NGHS means being part of something special: a team invested in you as a person, an employee, and in helping you reach your goals.

  
  NGHS: Opportunities start here.

  Northeast Georgia Health System is an Equal Opportunity Employer and will not tolerate discrimination in employment on the basis of race, color, age, sex, sexual orientation, gender identity or expression, religion, disability, ethnicity, national origin, marital status, protected veteran status, genetic information, or any other legally protected classification or status.

• About the company

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