Job Details

At Scripps Health, you will experience the pride, support, and respect that has been repeatedly recognized as one of the nation's Top 100 Places to Work. You'll be surrounded by people committed to making a difference in the lives of their patients and their teammates. So if you're opento change, go ahead and unlock your potential.

Join Scripps as Senior Director, Revenue Cycle where you will have primary accountability for the oversight of Coding, Clinical Documentation Integrity (CDI), and Health Information Management (HIM). The Senior Director manages the staff responsible for hospital and professional fee coding and CDI, ensuring quality documentation and clinical consistency.

This individual position is responsible for a diverse department, requiring skills in data-driven decision-making, process improvement/lean management, and customer relationship management.

The ideal candidate will possess a deep knowledge of industry best practices in technology and workflow. The Senior Director will use these skills and experience to partner with stakeholders to develop an organization-level roadmap of process and technology improvements to reduce provider burden and maximize patient experience while increasing efficiency. This position is responsible for the strategic direction of HIM across the health system centered on improved accuracy and efficiency.

Primary job duties include:

1. Develop policies and procedures across the system for greater efficiency, reduced variation, and increased patient satisfaction.
2. Promote point-of-service (POS) tools, techniques, and measurements.
3. Enhance centralized business office to reduce errors and facility costs.
4. Serve as key participant in the design, implementation, and support of IS Core systems.
5. Optimize hospital patient revenue.
6. Oversee and lead system hospital and professional fee coding and clinical documentation integrity (CDI).
7. Participate in the formulation of objectives and strategies for integrating coded clinical information to support goals for patient care, teaching, research, and optimizing management of resources.
8. Serve as a coding subject matter expert for the system, participating in various business operations and clinical committees.
9. Accountable for active daily management of Discharged Not Billed (DNB) work queues to assure targets are consistently met.
10. Ensure appropriate staffing levels and adherence to fiscal targets.
11. Develop and manage key coding and CDI performance indicators and metrics.
12. Oversee a comprehensive quality assurance and productivity program for coding and CDI staff.
13. Collaborate with physician and operational leadership to optimize workflows and technology.
14. Demonstrate in-depth working knowledge of ICD, CPT, MS-DRGs, and APR-DRGs code classifications/groupers with the ability to analyze and trend key metrics including CMI.
15. Develop and manage quality standards for the area. Oversee quality validation on first listed diagnoses, secondary diagnoses, E&M levels, and Hierarchical Condition Categories (HCCs) for accuracy and compliance as relates to Outpatient CDI. Monitor Risk Adjustment Factor (RAF) Scores.
16. Direct instructions and education activities for all Outpatient providers and ancillary staff across the system, in collaboration with clinic managers, CDI Educators, Physician Advisors, and coding departments, on coding and documentation related issues. Promote compliance with CMS, third-party payers, NCDs, and LCDs, coding, and billing regulations. Oversee the development and coordination of ongoing CDI education for new staff, including physicians, coders, nurses, and allied health professionals.
17. Manage and provide oversight of the Clinical Documentation Integrity Program to ensure optimal documentation and program effectiveness.
18. Direct and oversee the coding/abstracting activities in accordance with policies and procedures, external agency requirements, AHA's Coding Clinic, and other relevant industry standard guidelines.
19. Provide input to coding and medical record documentation guidelines to assure compatibility and compliance with all regulatory, third-party, and organization policies.
20. Provide input to the direction for the establishment and maintenance of documentation standards and policies and procedures related to coding and CDI activities.
21. Oversee and manage coding denial management activities.
22. Communicate clearly, proactively, and concisely with all key stakeholders.

This Director position is eligible to participate in the Director Incentive Plan.

Position is located in La Jolla and does require residence in San Diego.