[Remote] Executive Director of Clinical Documentation Improvement

Note: The job is a remote job and is open to candidates in USA. Wellstar Health System is a prominent healthcare organization dedicated to enhancing the health and well-being of individuals. They are seeking an Executive Director of Clinical Documentation Improvement to oversee the CDI Program, ensuring accurate clinical documentation and promoting effective review processes. The role involves collaboration with various healthcare teams and leadership in maintaining compliance and operational excellence within the department.ResponsibilitiesDevelops and manages the Documentation Improvement Department initiativesOversees the daily operations of the acute care and WellStar Medical Group CDI departmentsEnsures successful execution of strategies that contribute to system goals: a) Proficient in translating complex systems into key initiatives and executing with effective change management and stakeholder engagementB) Must possess skills required to run a fiscally responsible program while ensuring constant improvement and demonstrating return on investment, value added from programC) Extensive knowledge of treatment and documentation methodologies, electronic medical record (EMR) and other technology capabilities, data collection and reporting techniques, and coding and classification systemsD) Maintain expertise in various regulatory, guideline and quality criteria and requirements related to quality, coding, billing and clinical documentationE) Demonstrated ability to provide leadership and direction to Documentation Department Staff and coding specialists with relation to Clinical Documentation issues and establishes programs for the team to ensure compliance with productivity & quality standardsF) Knowledge of insurance regulations and Medicare and Medicaid guidelines, ACO and other payment models, Vizient and other quality algorithms and criteriaG) Develop and manage to departmental budgetsH) Ensure that the key metrics related to documentation improvement such as CMI are on target and explainableIdentify Clinical Documentation opportunities to collaborate, educate, and improve in order to achieve strategic goalsTake the lead on communication and documentation improvement initiatives with physicians, nurses, coding, quality, billing and other members of the health care team, working independently to resolve such issuesLead performance improvement initiatives in the areas of opportunity to improve documentation tools and clinical dataSubject Matter Expert in data analysis and clinical documentation to help teams determine root causesDetermines trends and helps create action plans based on internal and external data such as PEPPER, Vizient, financial reports, etcInternal Coding Audit DataCoding Educator DataCoding Quality Manager DataDevelop & Oversee Audit Programs & Ensure the Accuracy of External Reporting Through Implementing Data Quality Programs for: a) Risk Adjustment Factor-Based Payments (i.e., shared savings) b) ACO Payments c) Vizient, Leapfrog d) Accurate payment with all other payors within scopeOversee coding and data quality educational program based on the action plans and identified needs. Working with a broader audience, med staff committees, service lines, Business Intelligence, etcPerforms other duties as assignedComplies with all Wellstar Health System policies, standards of work, and code of conductSkillsBachelors Health Information Management or Bachelors Nursing or Masters Other-PreferredAll certifications are required upon hire unless otherwise statedMinimum 10 years of progressive healthcare experience with at least five (5) years of CDI, nursing or HIM leadership experienceAdvanced clinical expertise and extensive knowledge of complex disease processes, clinical data analysis and reporting and acute care, medical group and health plan experienceSkill in identifying problems and recommending solutionsSkill in preparing and maintaining records and written reportsSkill in establishing and maintaining effective working relationships with physicians, hospital staff and vendorsAbility to interpret, adopt, and apply guidelines and proceduresAbility to analyze complex scenarios and apply critical thinkingExtensive knowledge of reimbursement systemsExtensive knowledge of federal, state, and payer-specific regulations and policies pertaining to documentation and codingCompany OverviewAt Wellstar Health System, our mission is to enhance the health and well-being of every person we serve. It was founded in 1993, and is headquartered in Augusta, Georgia, USA, with a workforce of 10001+ employees. Its website is https://www.wellstar.org/locations/hospital/childrens-hospital-of-georgia.Company H1B SponsorshipWellstar Health System has a track record of offering H1B sponsorships, with 3 in 2026, 22 in 2025, 18 in 2024, 13 in 2023, 14 in 2022, 18 in 2021, 12 in 2020. Please note that this does not guarantee sponsorship for this specific role.