Sr. Manager - Clinical Documentation Integrity

Company: Stamford American International Hospital
Location: Pleasanton
Posted on: July 4, 2025

Job Description:

1.0 FTE Full time Day - 08 Hour R2547132 Hybrid 109012014 Shared Svcs Rev Cycle CDI TV Finance & Revenue Cycle PLEASANTON, 5555 W. Las Positas Blvd., California If youre ready to be part of our legacy of hope and innovation, we encourage you to take the first step and explore our current job openings. Your best is waiting to be discovered. Day - 08 Hour (United States of America) This is a Stanford Health Care job. A Brief Overview This position facilitates the vision and CDI program strategy, as determined in partnership and as identified by the CDI director. Focusing on operational performance, projects, innovations and process improvement opportunities. Manages daily operational management of the CDI program and members within the designated team. This position evaluates the adequacy and effectiveness of internal and operational controls designed to ensure that CDI processes and practices lead to appropriate execution of regulatory requirements and guidelines related to Hospital Billing and/or Professional Billing coding and CDI practices, including federal and state compliance standards. This position plays a key role in leading the initiative for reporting quality of care outcomes and in obtaining complete, accurate and compliant documentation for appropriate reimbursement of services provided and capture of clinical outcome measures. Uses clinical, coding, and CDI expertise to analyze, interpret and optimize CDI, coding, and outcomes performance through initiatives at the service line level, in very close partnership with quality, coding and IT. Manages, and is a key participant in, multidisciplinary and high-profile projects related to CDI, documentation, and outcomes performance, at the departmental and organizational levels. Leads and coordinates team efforts in clinical documentation integrity programs and outcomes optimization, relationship development and management, optimization of educational strategy. This position plays a key role in leading the initiative for reporting quality of care outcomes, operational and organizational process improvement, technology optimization through CDI departmental initiatives and industry leading practices. Locations Stanford Health Care What you will do Team Oversight: Manages Documentation Specialists, Supervisor and/or CDI Leads including activities such as goal setting, annual Performance Appraisal, coordinating scheduled time-off, allocating resources to cover the program throughout the hospital. CDI Quality: Manages the CDI accuracy/quality program , including the analysis of the findings, related performance improvement and optimization mitigation plans focused on continuous improvement to meet strategic goals and KPIs. Management of CDI audit programs and analysis of the findings, related to documentation and coding, to build physician engagement and multidisciplinary partnerships, identifying areas of individual and team opportunity, and facilitate short and long-term resolutions. Program Development: Coordinates the development of clinical documentation programs to improve the accuracy of documentation and the quality of patient care reported. Leads multidisciplinary and multi-departmental documentation initiatives to achieve strategic goals and objectives. Optimizes medical-center-wide clinical documentation integrity program teams, with guidance from CDI director Subject Matter Expert: Serve as a subject matter expert and authoritative resource on interpretation and application of CDI practices, coding rules and regulations and conducts risk assessments of potential and detected compliance deficiencies, as well as documentation improvement opportunities. Acts as a consultant to quality managers, coding leadership, management team, medical staff and health care staff regarding outcome and code-related data performance and clinical documentation opportunities Acts as expert in the areas of ambiguous or conflicting information in the medical record, CDI practices, CDI innovation, coding, outcome performance impact and optimal resource utilization Developing Partnerships: Manages relationships with key organizational and industry partners, including quality, compliance, coding, case management, clinical providers, other multidisciplinary teams. Coordinates the development of working sessions of multi-disciplinary teams in goal setting and problem solving. Responsibility for management and optimization of the positive relationships between CDI and business partners and customers across a variety of teams and roles. Analytics & Process Improvement: Coordinates data collection and analysis, in collaboration with quality teams, related to patient care activities, documentation opportunities, coding opportunities and clinical outcome performance gaps. Leads and manages departmental portfolio of multidisciplinary and multi-departmental CDI projects to achieve strategic goals and objectives. Partners with key leaders within IT and other related areas to create and optimize documentation tools, process and strategies to reduce administrative burden on our providers, while maintaining high quality and integrity documentation. Education Qualifications Bachelor’s Degree in Nursing, Medicine, Health Information Management or similarly related field of study Master’s Degree, preferred At least one currently active: • CCDS, CCDS-O, CDEO, CDEI or CDIP certification or similar CDI certification At least two currently active: • COC, CPC, CIC, CRC, CPMA or CCS certification, or similar • Revenue cycle certification (CRCR, CSPR, CSPPM, etc) or similar • Health Care Quality (HACP, CPHQ, HCQM) certification or similar • Case Management, utilization review and/or safety Certification (CCM, HCQM, CMGT-BC, CPUR, CPPS, CPHRM, CCMC) or similar • Health Information Certification (RHIT, RHIA, CEHRS) • Clinical research certification (ACRP-CP, CCRA, CCRC, CPI, ACRP-MDP, etc) or other research certification • Physician Educator Certificate Program (PECP) certification, Certified Nurse Educator (CNEcl, CNE, ACE, etc), AHIMA approved trainer certification (ICD-10 CM, ICD-10 CM/PCS, or CDI) or other education certification • Project Management (CAPM, PMP, ACRP-PM) or other project management certification or similar • Process/performance improvement certification (Lean, Six Sigma, CHPI, CPT, etc) or similar • Analytics and/or data management certification (CAP, CDMP, CHRS, CSBI) or similar • EHR (Epic, CEHRS, 3M/Solventum) certification, or other medical technology certification • Privacy, Compliance and/or Security (CPHS, CHPSE, HCISPP, RUHD, CHC, CHPC CPCO) certification or similar Experience Qualifications Five (5) years of progressively responsible and directly related inpatient clinical experience, data analytical experience or inpatient coding/revenue cycle experience and At least 5 years of direct CDI related work experience and Three (3) years of supervisory/management responsibility, preferred Required Knowledge, Skills and Abilities Demonstrates ability to analyze problems and issues and understand the regulatory, reimbursement and outcomes performance impact of those decisions. Demonstrates critical thinking skills, able to assess, evaluate, and teach. Demonstrates knowledge of and application of AHIMA and ACDIS Ethical Standards. Ability and willingness to seek out and accept change. Expertise in MS-DRGs, ICD-10 coding, Quality and other performance comparison data bases (Vizient, etc) and CDI practices, required. Expertise in industry-leading CDI practices and knowledge distribution to multidisciplinary teams. Proficiency with Microsoft Applications, including word processing, spreadsheets and presentation software. Extensive knowledge and experience in reporting software, electronic medical record systems, CDI/Coding software, AI technology and the optimization of technology tools within the CDI context. Demonstrated leadership ability. Maintains industry leading knowledge of CDI, Coding and outcomes performance management within the context of regulatory, compliance and industry best practice rules and regulations regarding CDI and coding. Ability to work with senior management, physicians, and medical center staff with various levels of education and experience. Ability to develop and maintain strong, collaborative and supportive working relationships with CDI peers, physicians and other clinical professionals. Must have demonstrated effective interpersonal, verbal and written communication skills in dealing with multidisciplinary teams and variety of ongoing activities. Knowledge of project management processes and systems. Skilled and experienced in data and statistical analysis and reporting practices pertaining to quality improvement and program evaluation, including qualitative reporting of results. Demonstrated organizational, project management skills. Ability to work independently, creatively, and innovation-focused in high-volume, fast- paced, and highly political work environments. Ability to lead teams and manage high-profile projects to produce results within schedule and budget. Ability to plan, organize, motivate, mentor, direct and evaluate the work of others. Demonstrated leadership ability, organizational savviness, and critical thinking skills. Ability to work effectively with individuals at all levels of the organization. Demonstrated organizational and critical thinking skills, ability to assess, evaluate and teach. Ability to provide advice and counsel clients/customers on a broad range of CDI, coding, outcomes and documentation matters regarding effectiveness, compliance and efficiency. Knowledge of analytical research procedures and methods. Ability to assess data and reporting tools or make recommendations regarding their improvement or enhancement. Ability to provide concise reports of activities and results. Ability to successfully navigate multiple projects and responsibilities Ability to develop and maintain strong, collaborative and supportive working relationships with peers, physicians and other clinical professionals. Knowledge of statistical analysis and reporting practices pertaining to quality improvement and program evaluation. Ability to work independently in performing duties with minimal supervision with a high degree of self-motivation. Expertise in developing and delivering training and education to clinical, CDI and coding professionals regarding CDI practices, coding, and documentation requirements, as well as knowledge distribution to multidisciplinary teams. These principles apply to ALL employees: SHC Commitment to Providing an Exceptional Patient & Family Experience Stanford Health Care sets a high standard for delivering value and an exceptional experience for our patients and families. Candidates for employment and existing employees must adopt and execute C-I-CARE standards for all of patients, families and towards each other. C-I-CARE is the foundation of Stanford’s patient-experience and represents a framework for patient-centered interactions. Simply put, we do what it takes to enable and empower patients and families to focus on health, healing and recovery. You will do this by executing against our three experience pillars, from the patient and family’s perspective: Know Me: Anticipate my needs and status to deliver effective care Show Me the Way: Guide and prompt my actions to arrive at better outcomes and better health Coordinate for Me: Own the complexity of my care through coordination Equal Opportunity Employer Stanford Health Care (SHC) strongly values diversity and is committed to equal opportunity and non-discrimination in all of its policies and practices, including the area of employment. Accordingly, SHC does not discriminate against any person on the basis of race, color, sex, sexual orientation or gender identity and/or expression, religion, age, national or ethnic origin, political beliefs, marital status, medical condition, genetic information, veteran status, or disability, or the perception of any of the above. People of all genders, members of all racial and ethnic groups, people with disabilities, and veterans are encouraged to apply. Qualified applicants with criminal convictions will be considered after an individualized assessment of the conviction and the job requirements. Base Pay Scale: Generally starting at $81.53 - $108.02 per hour The salary of the finalist selected for this role will be set based on a variety of factors, including but not limited to, internal equity, experience, education, specialty and training. This pay scale is not a promise of a particular wage. Saving Lives and Changing the Future of Medicine Stanford is a part of the top 10 highest ranked Level 1 Trauma Magnet Facilities in the U.S. Combining clinical care, research, and education, our team provides compassionate, coordinated and personalized care for the unique needs of every patient. As the only Level I trauma center between San Francisco and San Jose, Stanford Health Care delivers clinical innovation across its inpatient services, specialty health centers, physician offices, virtual care offerings and health plan programs. With a state-of-the-art hospital, more than 2,800 medical staff and more than 1,300 residents and fellows, Stanford Health Care is committed to making a lasting impact through research, education and clinical care. Benefits Stanford offers exceptional benefits and competitive pay to ensure our staff feels supported in and outside of their work. Specific roles are eligible for shift differential pay, sign-on/relocation bonus, etc.

Keywords: Stamford American International Hospital, Fairfield , Sr. Manager - Clinical Documentation Integrity, Healthcare , Pleasanton, California