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Program Manager Clinical Documentation Integrity - Full-Time, Days

Location Chicago, Illinois Business Unit Northwestern Memorial Hospital Job REQID 57680 Job Function Quality/Business Development/Process Improvement Shift Day Job (1st) Apply Now

At Northwestern Medicine, every patient interaction makes a difference in cultivating a positive workplace. This patient-first approach is what sets us apart as a leader in the healthcare industry. As an integral part of our team, you'll have the opportunity to join our quest for better healthcare, no matter where you work within the Northwestern Medicine system. At Northwestern Medicine, we pride ourselves on providing competitive benefits: from tuition reimbursement and loan forgiveness to 401(k) matching and lifecycle benefits, we take care of our employees. Ready to join our quest for better?

Description

The Program Manager of Clinical Documentation Integrityreflects the mission, vision, and values of Northwestern Medicine (NM), adheres to the organization’s Code of Ethics and Corporate Compliance Program, and complies with all relevant policies, procedures, guidelines, and all other regulatory and accreditation standards.

  • Responsible for leading clinical documentation integrity (CDI) efforts in support of NM and business unitstrategic goals. Responsible for managing relationships with key stakeholders at multiple business units to advance financial and quality outcomes for NM and each business unit. Functional areas of responsibility include leading administrative planning and implementation activities for the NM CDI Program, including but not limited to, team communications, data and scorecard design and distribution, budget oversight, and external consultant site visits and assessments.  This will include using standard project management methodologies throughout a project lifecycle with strategic and operational importance to the department and organization, by developing work plans and metrics. The monitoring of work plans and metrics to assure activities are on-time and on budget, coordinating the internal and external resources to execute activities, and completing activities as assigned.  Key to this role is the ability to lead and facilitate verbal and written conversations with stakeholders across NM. 

Description

  • Leads administrative planning initiatives for the NM CDI Program.
  • Coordinates external vendor bi-annual assessment visits for both onsite and virtual activities
  • Collaborates with Managers of Clinical Documentation, the Director of Clinical Documentation, Vice President of Clinical Documentation, and Medical Director Leadership to align clinical documentation integrity work efforts to the extent possible throughout NM.
  • Collaborates with leaders across NM to advance Clinical Documentation work efforts. 
  • Key Stakeholders include but are not limited to, Managers of Clinical Documentation, Director of Clinical Documentation, System Clinical Coding Leaders, Business Unit and System Clinical Quality Managers and Directors, Business Unit Nutrition Managers, and Business Unit Clinical Managers.
  • Assists with and completes special project work as assigned by Clinical Documentation program leadership. 
  • Supports collection and preparation of internal CDI data and sends it to third-party consultants.
  • Supports program leadership in the secondary review process in oversight, issue resolution, and logic build with the external vendor.
  • Effectively manage problems that arise within the project team or issues with clients, and recommend mitigation strategies as needed to achieve the desired results
  • Responsible for developing and maintaining productive and cordial relationships with clients and team members, serving as a link between multiple parties and entities. Must be able to effectively manage problems that arise within the team or issues with stakeholders to achieve the desired results.
  • Leads implementation initiatives for the NM CDI Program
  • Collaborates with CDI Program Leadership to assess opportunities with newly integrated NM hospitals to align programs to the NM model. 
  • Instructs Clinical Documentation team and distributes updated information on Clinical Documentation and Coding concepts, federal rule changes, and risk methodology updates.
  • Stay up-to-date on clinical documentation through the lens of local and national quality and ranking methodologies, including but not limited to, U.S News and World Report, Vizient, Leapfrog, the CMS Star Rating, and payer contracts, and assist the Managers of Clinical Documentation in implementing key strategies to teach and deploy the team in the manner necessary to effect change
  • Leverages NM network to initiate conversations, identifies root causes and resolution, and aligns resources.
  • Analyzes case review data to accurately and cogently reflect patterns and trends that require improvement using various external data systems to complete primary and secondary research, competitive and data analysis
  • Participates in key strategies for the review and reporting of DRG appeals and denials
  • Responsible for developing and managing the following for assigned projects; budgets, resource allocation, information distribution, meeting facilitation, and overall performance reporting
  • Prepare and reviews deliverables for leadership approval. Ensure project documents are complete, current, and stored appropriately.
  • Establish and execute effective and efficient communication mechanisms, which enable the continuous exchange of project status, ideas, and information, and project developments among team members, NM Executives (project sponsors), and vendor partners. 
  • Apply standard project management methodologies throughout the project lifecycle including; analysis, design, implementation, verification as well as value measurement definition
  • Participate and Chair a minimum of one NM Clinical Documentation committee
  • Coordinates physician, residents, APP, Department, and/or Division in-services and education across the system as well as develop educational slides.
  • Creates and maintains educational pocket card supplies and distribution.
  • Provide support on recurring and/or ad hoc projects.
  • Create and oversee Purchase Orders, tracking contract timelines and amounts to ensure they are on track.
  • Monitors billing and ensure expenses are appropriately tracked
  • Track metrics and other key performance indicators to measure project and deliverable success
  • Time management expert who can prioritize tasks in accordance with urgency and complexity as well as pivot focus as needed
  • Serve as a liaison and problem solver to Clinical Documentation Leadership regarding administrative issues (e.g. budget variances, external reporting)
  • Support and serve as a resource for Senior Leadership as necessary
  • Assist CDI Leadership with Process Improvement projects and additional initiatives
  • Prepare and reviews applicable deliverables for leadership review and approval.
  • Create and execute work plans and revises as appropriate to meet changing needs and requirements.
  • Train new leadership on POs, invoicing process as well as Vizient reporting as well as Guiding them thru NMI
  • Serve as an NM system content expert
  • Develop, manage and maintain NM's internal Intranet CDI Page
  • May need to provide administrative support to Executive Leadership

Qualifications

Required:

  • Bachelor's Degree in Business Administration, Healthcare Management, Communications, or related field. 
  • Minimum of 7 years experience in a healthcare environment.
  • Strong Knowledge of Microsoft: Word, Excel, PowerPoint, Project
  • Demonstrated project management and organizational skills, demonstrated analysis and problem-solving skills, excellent oral and communication skills, and demonstrated ability to effectively establish and maintain working relationships with peers and constituents at all levels of the organization. 
  • Ability to work with a diverse group of healthcare professionals in a matrix environment.
  • Experience managing large, complex projects

Preferred:

  • Master’s degree in MBA or MHA preferred (required in place of work experience).

Equal Opportunity

Northwestern Medicine is an affirmative action/equal opportunity employer and does not discriminate in hiring or employment on the basis of age, sex, race, color, religion, national origin, gender identity, veteran status, disability, sexual orientation or any other protected status.

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