Description

Purpose:
Supervise the staff performing CDI optimization for inpatients concurrently, as well as post coding DRG optimization, including the coordination of training/education related initiatives for the CDI program. Provide direction and coordination of the work flow among all necessary hospital groups/departments. Ensure accuracy and timely input of clinical documentation to support severity of illness and risk of mortality scores as well as optimal reimbursement by payers. Interact with physicians regarding clarifications necessary for appropriate coding and clinical documentation standards.

This position will work on site 2 days per week and will travel to other UPMC central sites as needed.  Opportunity to work hybrid.

Responsibilities:

• Adhere to human resource policies and procedures. Assist with the performance reviews for all direct reports.
• Assist with the one-on-one education with staff identified as having quality or productivity related deficits based on audits conducted within the department. Conduct audits on staff to ensure quality indicators are met. Review findings with appropriate personnel.
• Review work flow to maximize automated systems. Assist with training of new staff.
• Coordinate all work distribution for CDI staff.Provide education and audit related feedback to enhance the coding knowledge base of all inpatient coding.
• When necessary, complete CDI functions to ensure minimal backlogs exists.
• Perform CDI related work duties (i.e., work CDI patient list and markers regularly to ensure work production requirements are met).
• Perform duties and responsibilities in a fashion that coincides with the service management philosophy of UPMC including the demonstration of the basics of service excellence towards patients, visitors, staff, peers, physicians and other departments within the medical center.
• Assist with CDI software program testing and marker evaluations, including providing feedback to vendor and medical director of coding. Investigate staff issues and provide feedback as appropriate on resolution.
• Provide education related sessions on CDI requirements during staff meetings and other sessions as applicable, including physicians.
• Assist with the development and implement policies and procedures for processes performed for the CDI program. Provide support, training, develop and guidance to staff in their daily activities.

Qualifications

• Certified Coding Specialist (CCS) OR Certified Professional Coder (CPC) OR Registered Health Information Administrator OR Registered Health Information Technician (RHIT) OR Registered Nurse (RN)
• Three years of previous clinical documentation improvement specialist) AND 3 years of experience with the Prospective Payment System and DRG selection/assignment and optimization;
• Bachelor's degree or equivalent years of experience in related field.
• Knowledge of computer technology, quality assurance activities, DRG, Quality Insights/Utilization review background is highly preferred.
• Strong experience with electronic documentation and electronic medical record content.
• Prior supervisory experience preferred. 
• Ability to communicate with staff, physicians, healthcare providers, and other health care system personnel in a professional and diplomatic manner required.

Licensure, Certifications, and Clearances:

• Act 34 with renewal

UPMC is an Equal Opportunity Employer/Disability/Veteran

Total Rewards

More than just competitive pay and benefits, UPMC’s Total Rewards package cares for you in all areas of life — because we believe that you’re at your best when receiving the support you need: professional, personal, financial, and more.

Our Values

At UPMC, we’re driven by shared values that guide our work and keep us accountable to one another. Our Values of Quality & Safety, Dignity & Respect, Caring & Listening, Responsibility & Integrity, Excellence & Innovation play a vital role in creating a cohesive, positive experience for our employees, patients, health plan members, and community. Ready to join us? Apply today.