Director, Risk Management-Remote

Director Revenue Cycle Inpatient Clinical Documentation Improvement & Payer Audit Join to apply for the Director Revenue Cycle Inpatient Clinical Documentation Improvement & Payer Audit role at Henry Ford Health Director Revenue Cycle Inpatient Clinical Documentation Improvement & Payer Audit Join to apply for the Director Revenue Cycle Inpatient Clinical Documentation Improvement & Payer Audit role at Henry Ford Health The Director Revenue Cycle Inpatient Clinical Documentation Improvement & Payer Audit is a Local Southeastern, MI role with flexible Hybrid opportunity if living in Michigan. Our HFH office for this position is located in Troy, MI for any in Office time* - The Director Revenue Cycle Inpatient Clinical Documentation Improvement & Payer Audit is a Local Southeastern, MI role with flexible Hybrid opportunity if living in Michigan. Our HFH office for this position is located in Troy, MI for any in Office time* Henry Ford Health (HFH), one of the leading healthcare systems in Michigan, continues to grow and innovate, driven in part by its joint venture with Ascension, launched on October 1, 2024. As we expand, we are seeking a highly skilled and experienced Clinical Documentation Improvement (CDI) Program Director to provide concentrated daily oversight of Inpatient Clinical Documentation Improvement and Payer Audit teams. The Program Director will partner with clinicians, coders, payers, and other members of the healthcare team to ensure accurate and timely clinical documentation in the medical record. Through collaboration with members of the team and revenue cycle leadership, identifies departmental and business unit priorities, establishes goals, and implements strategies designed to foster a culture of innovation, employee engagement, and exceptional business performance. Daily Operations - Partners with leaders from other business units to understand and mitigate barriers. - Oversight of analysis of employee/operational performance; Manages CPT//ICD-10 code usage to ensure accurate, effective, communication with physicians regarding coding trends and accurate coding to maximize reimbursement. - Identifies performance gaps and creates action plans to mitigate. - Recruits and develops leaders, builds a culture of high performance and engaged workforce. - Participates in data collection for performance measures, investigates opportunities, and implements solutions for optimization. - Demonstrates belief in the mission of Henry Ford Health through the ability to articulate, interpret, and incorporate its mission into departmental goals and objectives. - Establishes priorities and long and short-term strategic goals of the department with the assistance of the management team. May develop and/or lead committees/teams related to coding or documentation, denials, regulatory changes, performance improvement, and compliance. - Ensures that information systems support current and future needs of the department. - Works closely with information technology in transition planning including, but not limited to, testing, installation, and education of staff to produce and maintain high quality data integrity. - Creates and manages strategic partnerships with vendors and third-party systems to ensure optimization of costs and quality. - Monitors performance of external vendors with monthly performance metrics and standards compared to benchmarks. - Ensures concurrent Clinical Documentation Improvement activities are following local, state, and federal guidelines. - Responsible for leadership within clinical teams to promote documentation standardization for the health system. - Maintains revenue cycle accountability to the business units. - Oversees/directs the development of policies and procedures for the department. - Supports the standards set forth in the HFH Code of Conducts by creating an atmosphere of commitment to legal and ethical standards. - Creates and manages strategic partnerships with on shore and off-shore vendors and third-party systems to ensure optimization of costs and quality. - Creates a process for escalation of payer opportunities including managed care, legal and other stakeholders. - Serves as an internal consultant on industry best practice, denials, payer performance, CMS regulations, documentation, and compliance. - Responsible for maintaining regulatory compliance with external agencies and state and federal regulations for medical record and coding related standards for each business unit and the health system. Ensures staff is kept informed and educated on process and regulatory changes. - Assures support services function meets all current regulatory compliance and HIPAA transaction requirements and keeps current with MS-DRG and ICD- 10/CPT coding rules and regulations. - Works with risk management, legal counsel, and administrative staff, key departments, providers, and committees to ensure that the organization maintains appropriate compliance including privacy and security and confidentiality policies, procedures, forms, coding, and materials that reflect current organizational practices and regulatory requirements at the local, state, and national levels. Bachelor’s degree in Health Information Management, Accounting, Business Administration, Finance, or other business related field. - Knowledge of best practices related to revenue cycle operations. - Experience at a large, complex, integrated healthcare organization, preferred. - Ability to estimate time frames and meet projected deadlines. - Ability to work with a variety of individuals in executive, managerial and staff level positions. - Demonstrate experience in all areas of medical record functions, including privacy & compliance regulations. Shift: Day Job - Union Code: Not Applicable IndustriesHospitals and Health Care, Insurance, and Wellness and Fitness Services Referrals increase your chances of interviewing at Henry Ford Health by 2x Director of Digital Banking Channels & Support Operations Director of Operations - Kirk Gibson Center for Parkinson's Wellness Director of Operations - Detroit, Michigan Director of Health and Safety (Operations Excellence) Provider Operations Revenue Cycle - Senior Manager Provider Operations Revenue Cycle - Manager Partner, Sustainable Operations (Director Level) We’re unlocking community knowledge in a new way. Experts add insights directly into each article, started with the help of AI. #