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PRMO:, established in 2001, Patient Revenue Management Organization (PRMO) is a fully integrated, centralized revenue cycle organization supporting all of Duke Health, including Duke University Hospital, Duke Regional Hospital, Duke Raleigh Hospital, the Private Diagnostic Clinic, and Duke PrimaryCare. The PRMO focuses on streamlining the revenue cycle through enhanced management of scheduling, registration, coding, HIM operations, billing, collections, cash management, and customer service. The Mission of the PRMO is delivering quality service by enhancing the patient experience, providing financial security, and preserving Duke's reputation and mission of advancing health together. Our Vision is to be recognized as a world class innovative revenue cycle organization that values our people, patients and performance.
This position may have an opportunity to work remotely. All Duke University remote workers must reside in one of the following states or districts: Arizona; California; Florida; Georgia; Hawaii; Illinois; Maryland; Massachusetts; Montana; New Jersey; New York; North Carolina; Pennsylvania; South Carolina; Tennessee; Texas; Virginia or Washington, DC.
General Description of the Job Class
Organization, daily oversight of processes, and monitoring and management of all members of the Clinical Documentation Integrity (CDI) team at Duke Medicine. The manager will report directly to the Director of Clinical Documentation Integrity.
Duties and Responsibilities of this Level
Daily operations responsibilities for the Clinical Documentation Integrity Manager include, but are not limited to:
Oversight and management of department operations and personnel. Assessment and division of total daily workload among Clinical Documentation Integrity Specialists (CDIs) to provide equal share of patient census, complexity of work, and ability to complete assignments. Monitoring of daily process for all team members. Facilitation of communication between inpatient coders and CDI team. Reconciliation of all CDI charts. Accurate recording of CDS impact on record.
Communication with Coding Manager and CDI Director of case and resolution
Collaboration in planning, analysis, procedure changes, scheduling and related administrative duties.
Assists CDI Director in development of future state policies and procedures.
Facilitation of issue identification and resolution. Effective communication to team and administration regarding any barriers to success identified within the CDI department
Management of staffing to ensure appropriate allocation and compliance with goals and objectives.
Assessment, when necessary, of equality of workload based on case complexity and patient census
Monitoring and reporting of quality and financial performance in collaboration with Strategic Services Associate
Assurance of compliance with government health regulations, JCAHO guidelines, CMS quality requirements and customer service standards.
Design and recommendation of enhancement and cost saving strategies.
Resolution of interdepartmental issues to ensure consistency in quality, procedure and policy application.
Development, monitoring and implementation of programs to enhance customer service, develop skills and improve scope of service for all CDI team members.
Participation in manager meetings and relevant committees as assigned by Director.
Assisting the HIM department in facilitation of the physician query process.
Identification of opportunities for intradepartmental and interdepartmental operational improvements.
Reporting of CDI metrics to organization leadership to demonstrate impact of the program.
Maintenance of accurate records of review activities to comply with departmental and regulatory agency guidelines.
Participation in the daily workload and function in the role of Clinical Documentation Integrity Specialist, if deemed necessary by team staff shortage.
Performance of other duties as assigned.
Required Qualifications at this Level
Bachelor's Degree in Nursing, PA (Physician's Assistant) or NP (Nurse Practitioner) or Doctorate degree in a medically related field Required. Master's Degree in Nursing or Healthcare preferred.
Experience in nursing required; minimum five years supervisory or management experience in healthcare required. Two years' experience in CDI required; CCDS, CDIP, or CCS required.
Degrees, Licensure, and/or Certification:
Current licensure as an RN, NP, PA or licensure in the specific medical field associated with a Doctorate degree.
CCDS or CDIP or CCS certification required.
Knowledge, Skills, and Abilities:
Excellent communication skills, oral and written. Ability to analyze data, perform multiple tasks and work independently. Must be able to develop and maintain professional, service-oriented working relationships with patients, physicians, co-workers and supervisors. Must be able to understand and comply with policies and procedures.
Duke is an Affirmative Action/Equal Opportunity Employer committed to providing employment opportunity without regard to an individual's age, color, disability, gender, gender expression, gender identity, genetic information, national origin, race, religion, sex, sexual orientation, or veteran status.
Duke aspires to create a community built on collaboration, innovation, creativity, and belonging. Our collective success depends on the robust exchange of ideas-an exchange that is best when the rich diversity of our perspectives, backgrounds, and experiences flourishes. To achieve this exchange, it is essential that all members of the community feel secure and welcome, that the contributions of all individuals are respected, and that all voices are heard. All members of our community have a responsibility to uphold these values.
Essential Physical Job Functions: Certain jobs at Duke University and Duke University Health System may include essentialjob functions that require specific physical and/or mental abilities. Additional information and provision for requests for reasonable accommodation will be provided by each hiring department.
As a world-class academic and health care system, Duke Health strives to transform medicine and health locally and globally through innovative scientific research, rapid translation of breakthrough discoveries, educating future clinical and scientific leaders, advocating and practicing evidence-based medicine to improve community health, and leading efforts to eliminate health inequalities.