Program Integrity Director Jobs in Miami, FL (NOW HIRING)

Location:
Miramar, Florida
At Memorial, we are dedicated to improving the health, well-being and, most of all, quality of life for the people entrusted to our care. An unwavering commitment to our service vision is what makes the difference. It is the foundation of The Memorial Experience.
Summary:
Responsible for managing the daily operations of inpatient clinical documentation integrity consistent with administrative, medical, ethical, regulatory and governmental requirements. Oversees improvement in the overall quality, completeness and accuracy of medical record documentation to ensure patient's acuity of care and severity of illness are accurately reflected in the medical record. Provides education to physicians and other care providers on documentation guidelines. Effectively manages Clinical Documentation Integrity Specialists (CDIS) covering Memorial Healthcare System (MHS) acute care facilities ensuring provider clarifications meet regulatory requirements.
Responsibilities:
Maintains thorough knowledge of ICD-10CM/PCS coding principles and guidelines; possesses substantial knowledge of MSDRG and APRDRG reimbursement systems and guidelines for compliant provider documentation clarification. Serves as an expert resource for all CDI and coding staff.Manages staff relations including performance management, staff satisfaction, and conflict management. Performs and oversees scheduling, recruitment, payroll, and updating clinical documentation integrity (CDI) policies and procedures. Evaluates and counsels CDI specialists' work performance, attendance, annual reviews, work schedule and paid leave requests. Conducts timely performance reviews within MHS required due dates. Orients and mentors new CDIS to MHS applications, workflow and Health Information Management (HIM) policies and procedures.Performs all other duties as assigned.Provides ongoing, one-on-one, or group education related to documentation integrity and compliance to physicians, extenders, nursing, clinical dieticians, wound care specialists, physical therapists and other allied health professionals as needed. Works closely with the Auditor, Clinical Documentation Integrity (CDI) Compliance to determine educational topics for staff training. Participates in MHS system-wide Quality and Patient Safety work groups to facilitate accurate and complete provider documentation. Oversees CDI collaboration with Quality Management and Population Health specialists to advise of Patient Safety Indicators (PSIs), Hospital Acquired Conditions (HACs) and Bundled Payments for Care Improvement (BPCI) admit diagnoses/Diagnosis Related Groups (DRGs).Determines work assignments, monitors employee work activities and schedules all training needs. Assures appropriate CDI coverage to perform initial and follow-up medical record reviews. Monitors staff compliance with CDI quality and productivity standards; advises employees of monthly quality and productivity results. Monitors electronic HIM CDI work queues daily.Works with Medical Director, HIM and MHS Chief Medical Officers (CMOs) to collaborate with the medical staff to ensure timely completion of physician clarifications to capture appropriate documentation. Generates CDI reports for MHS monthly operating review (MOR), facility Chief Financial Officers and CMOs to monitor provider clarification and response rates, impact on case mix index (CMI) and reimbursement.Maintains strict adherence to patient confidentiality according to MHS Standards and regulatory requirements.
Competencies:
ACCOUNTABILITY, CAPACITY MANAGEMENT, CUSTOMER SERVICE, LEADING BY COACHING, MANAGING PEOPLE, MEASURING WORK RESULTS, RESPONDING TO CHANGE, STANDARDS OF BEHAVIOR
Education and Certification Requirements:
Accredited Program (Required)Registered Health Information Technician (RHIT) - State of Florida (FL)
Additional Job Information:
Complexity of Work: Requires critical thinking skills, effective written and verbal communication skills, effective time management, decisive judgment and the ability to work with minimal supervision. Must be able to work in a stressful environment and take appropriate action. Ability to accurately determine the correct ICD-10-CM/PCS codes and MSDRG or APRDRG to hospitalized inpatients under CDI review. Proficient in basic computer skills including Microsoft Office applications, utilizing a computerized encoder and electronic medical record system. Ability to work well with physicians and other allied health staff. Demonstrates professional responsibility and fosters teamwork.
Required Work Experience: Three (3) years of clinical documentation integrity management experience.
Other Information: Additional Education Info: Graduate of an accredited school of HIM or nursing.Additional Credential Info: Must be a Registered Health Information Administrator (RHIA), Registered Health Information Technician (RHIT), Certified Coding Specialist (CCS), or Registered Nurse (RN).
Working Conditions and Physical Requirements:

• Bending and Stooping = 40%
• Climbing = 0%
• Keyboard Entry = 60%
• Kneeling = 40%
• Lifting/Carrying Patients 35 Pounds or Greater = 0%
• Lifting or Carrying 0 - 25 lbs Non-Patient = 40%
• Lifting or Carrying 2501 lbs - 75 lbs Non-Patient = 0%
• Lifting or Carrying > 75 lbs Non-Patient = 0%
• Pushing or Pulling 0 - 25 lbs Non-Patient = 40%
• Pushing or Pulling 26 - 75 lbs Non-Patient = 0%
• Pushing or Pulling > 75 lbs Non-Patient = 0%
• Reaching = 40%
• Repetitive Movement Foot/Leg = 0%
• Repetitive Movement Hand/Arm = 60%
• Running = 0%
• Sitting = 60%
• Squatting = 20%
• Standing = 60%
• Walking = 60%
• Audible Speech = 60%
• Hearing Acuity = 60%
• Smelling Acuity = 0%
• Taste Discrimination = 0%
• Depth Perception = 60%
• Distinguish Color = 60%
• Seeing - Far = 60%
• Seeing - Near = 60%
• Bio hazardous Waste = 0%
• Biological Hazards - Respiratory = 0%
• Biological Hazards - Skin or Ingestion = 0%
• Blood and/or Bodily Fluids = 0%
• Communicable Diseases and/or Pathogens = 0%
• Asbestos = 0%
• Cytotoxic Chemicals = 0%
• Dust = 0%
• Gas/Vapors/Fumes = 0%
• Hazardous Chemicals = 0%
• Hazardous Medication = 0%
• Latex = 0%
• Computer Monitor = 60%
• Domestic Animals = 0%
• Extreme Heat/Cold = 0%
• Fire Risk = 0%
• Hazardous Noise = 0%
• Heating Devices = 0%
• Hypoxia = 0%
• Laser/High Intensity Lights = 0%
• Magnetic Fields = 0%
• Moving Mechanical Parts = 0%
• Needles/Sharp Objects = 0%
• Potential Electric Shock = 60%
• Potential for Physical Assault = 0%
• Radiation = 0%
• Sudden Decompression During Flights = 0%
• Unprotected Heights = 0%
• Wet or Slippery Surfaces = 0%

Shift:
Primarily for office workers - not eligible for shift differential
Disclaimer: This job description is not intended, nor should it be construed to be an exhaustive list of all responsibilities, skills, efforts or working conditions associated with the job. It is intended to indicate the general nature and level of work performed by employees within this classification.
Wages shown on independent job boards reflect market averages, not specific to any employer. We encourage candidates to talk to their Memorial Healthcare System recruiter to discuss actual pay rates, during the hiring process.
Memorial Healthcare System is proud to be an equal opportunity employer committed to workplace diversity.
Memorial Healthcare System recruits, hires and promotes qualified candidates for employment opportunities without regard to race, color, age, religion, gender, gender identity or expression, sexual orientation, national origin, veteran status, disability, genetic information, or any factor prohibited by law.
We are proud to offer Veteran's Preference to former military, reservists and military spouses (including widows and widowers). You must indicate your status on your application to take advantage of this program.
Employment is subject to post offer, pre-placement assessment, including drug testing.
If you need reasonable accommodation during the application process, please call 954-276-8340 (M-F, 8am-5pm) or email TalentAcquisitionCenter@mhs.net