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Guidehouse

Advises agencies and runs regulated operations

Clinical Documentation Integrity Supervisor

Clinical Support & Patient AdministrationConfirmed live in the last 24 hours
Full-timeRemote in USARemote

About the Job

Requirements

  • A university degree is required, with a minimum of five years of prior relevant experience; relevant experience may be substituted for formal education or an advanced degree.
  • Must hold at least one of the following credentials: RHIA, RHIT, RN, MD, or an MD-equivalent clinical credential.
  • Must maintain required credentials and certifications throughout employment.
  • At least five years of acute care hospital clinical documentation integrity experience is required.
  • Familiarity with encoder use and diagnosis-related group assignment, including MS-DRG and APR-DRG methodologies.

Responsibilities

  • Oversee daily clinical documentation integrity assignments, adjust staffing to maintain coverage, and monitor productivity, utilization, compliance, key performance indicators, and monthly quality audits.
  • Ensure the clinical documentation integrity team has the tools, resources, and guidance needed to complete concurrent record reviews and initiate and follow up on provider queries.
  • Collaborate with facility clinical documentation integrity teams, client stakeholders, and internal leadership to support operations, technology use, policy and procedure updates, and timely escalation of program needs or risks.
  • Assess health system opportunities related to contractual requirements, clinical documentation integrity best-practice metrics, and program performance.
  • Support development and implementation of processes and initiatives to improve clinical documentation performance.
  • Coordinate priorities, track progress, and support execution of clinical documentation integrity initiatives using project management skills.
  • Communicate and collaborate with medical staff, clinical departments, and facility leadership as needed.
  • Maintain and demonstrate knowledge of clinical documentation integrity and coding process best practices.
  • Drive effective use of clinical documentation integrity technology tools, dashboards, and reporting capabilities.
  • Ensure the team meets key performance indicators and quality expectations.
  • Distribute daily review assignments evenly among clinical documentation integrity specialists.
  • Cover assignments for staff who are out of office, including closing pending queries, conducting re-reviews, and handling diagnosis-related group management matters.
  • Monitor clinical documentation integrity productivity and project utilization monthly.
  • Lead improvement of clinical data reporting quality and completeness through evidence-based knowledge, analysis, in-depth review, interpretation, identification of opportunities, communication, follow-up, and evaluation of concurrent and retrospective medical record documentation as required.
  • Monitor internal key indicator metrics and develop corrective action plans when metrics are not achieved.
  • Analyze and manipulate data, articulate outcomes, and report them to committees, including monthly facility-specific Utilization Review Committees and the Chief Medical Officer.
  • Conduct monthly quality reviews and present findings to the clinical documentation integrity Manager and Director.
  • Develop education for physicians and clinical documentation integrity staff as needed.
  • Participate in interviewing, hiring, and onboarding clinical documentation integrity specialists.
  • Communicate program updates, concerns, and out-of-scope client requests to the clinical documentation integrity Manager and Director.
  • Facilitate appropriate clinical documentation to support accurate diagnosis and procedure coding.
  • Collaborate with health information management coding staff to promote complete and accurate documentation and address negative trends.
  • Communicate with physicians, case managers, coders, and other care team members to ensure medical records reflect treatment, decision-making, and severity of illness.
  • Assign a working diagnosis-related group using official coding guidelines on initial and subsequent follow-up reviews.
  • Update the working diagnosis-related group for the Case Management team according to facility-specific processes.
  • Query providers concurrently and, when appropriate, retrospectively; collaborate with providers under facility policy to clarify medical record documentation.
  • Formulate compliant and credible clinical documentation clarifications addressing principal diagnosis, procedures, comorbidities, present-on-admission status, quality core measures, and patient safety indicators, following ACDIS, AHIMA, and CMS query guidelines.
  • Use clinical documentation integrity and encoder software to collect, track, and report outcomes and maintain data integrity.

Desired Qualifications

  • CCDS, CCS, or CDIP certification.
  • Strong clinical understanding of disease processes.

About the Company

Guidehouse

Advises agencies and runs regulated operations

Guidehouse advises government agencies and companies in regulated industries on strategy, technology and day-to-day operations. Its work combines business advice with software implementation and ongoing management, so a client uses the same firm to plan a change, build the systems and run the resulting processes. Teams modernize cloud platforms, apply data analysis and artificial intelligence, and redesign organizations to meet operating and regulatory requirements. Clients pay for consulting projects and technology work or outsource continuing business functions to its managed services teams. Guidehouse was founded in 2018 and is headquartered in McLean, Virginia.

Company size
10,001+
Company stage
Acquired
Total funding
$750K
Headquarters
McLean, VA
Founded
2018

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