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Health Information Data Compliance Manager - Health Information Management Services (MGR)

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POST DATE 9/2/2016
END DATE 11/17/2016

University of California - San Francisco Medical Centers San Francisco, CA

Company
University of California - San Francisco Medical Centers
Job Classification
Full Time
Company Ref #
11062
AJE Ref #
576076223
Location
San Francisco, CA
Experience
Entry Level (0 - 2 years)
Job Type
Regular

JOB DESCRIPTION

APPLY
Job Title

Health Information Data Compliance Manager - Health Information Management Services (MGR)

Job ID

11062

Job Code

0280

Job Family

Management

Location

Emeryville

Weekly Hours

40 ; 100%

Appointment Type

Career

Department

HIMS

Shift

8-hour Days

Full/Part Time

Full-Time

Union Information

This classification is not represented by a union

Favorite Job

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Our legacy of unsurpassed patient care and unceasing mission to integrate high-tech medical research with clinical operations has led to our prestigious standing as one of the top 10 hospitals in the nation according to U.S. News & World Report. As a premier health care institution dedicated to advancing health worldwide, UCSF Medical Center can also be the best place to advance and shape your career.

The medical center's employees are one of the most important reasons why we are recognized as one of the nation's best hospitals. To work at UCSF Medical Center is to be part of an institution that provides the highest caliber of care to patients; a nurturing, dynamic and team-oriented atmosphere in which to best use your skills and talents.


Department Description

The Health information/Medical Record Department is a support service of UCSF Medical Center whose primary purpose is to contribute to the quality of patient care through the development and maintenance of a comprehensive, centralized medical record system.

We currently maintain five million records and support the mission of the Medical Center by providing complete and accurate medical information for patient care, research and financial planning.


Job Summary

This position will report to the Director of Health Information Management Services and will be responsible for Data Quality and Education at UCSF Medical Center. This person will manage coding data compliance, coordinate the collection of data, serve as the expert for regulatory coding requirements related to both inpatient and outpatient coding and charges.

This position will be an integral participant in the UCSF enterprise wide implementation of ICD-10. Supervises staff (analyst and assistant levels) and ensures the quality of their work.
This Individual will facilitate a collaborative approach between Health Information Management Coding Professionals and all affected Departments of the Medical Center.

Serves as a HIM subject matter expert (SME), ensuring the accurate and compliant representation of the coding, severity of illness and DRG assignment in the medical record.

Assume leadership role for ICD-10 implementation; coordinate education and training of coding personnel; coordinate preparation and transition for ICD-10 within the medical center.

Responsible for coordination of coding quality reviews, analysis of findings and education of coding staff.

Evaluates coding in accordance with ICD-9, CPT4 and HCPCS coding standards and Medicare Regulations for inpatient and outpatient coding and ensures compliance with coding guidelines and appropriate reimbursement.

This job function involves extensive record review, interaction with physicians, HIM professionals, and CDS staff. Active participation in team meetings and education of staff in coding process is a key component.

The incumbent will establish systems to monitor review and validate the accuracy of all coded and abstracted data.

The position is responsible for determining the integrity of the coded data by organizing and maintaining an internal Coding Quality Control Program to monitor the accuracy, analysis, consistency and completeness of coding. This will include the determination and establishment of acceptable coding error rates based upon coding industry standards.

The position requires collaboration with the medical Center Compliance and Quality Improvement office to review and ensure that coding audits and documentation improvement activities are managed as required.

The incumbent will perform duties of reviewing clinical documentation, reimbursement rates and assessing the accuracy of the code assignment and the collection of required data for use by researchers, reporting agencies and financial evaluation.

This individual will perform their duties within Health Information Management Services, and other areas that adhere to data collection requirements. The information compiled from this process would directly impact decisions made by the Medical Center Administrative Group and Financial Services and federal, state, and TJC regulatory agencies.

The flexibility to orient and work at all UCSF Medical Center locations is required.

Living Pride Standards

Service Excellence

* Demonstrates service excellence by following the Everyday PRIDE Guide with the UCSF Medical Center standards and expectations for communication and behavior. These standards and expectations convey specific behavior associated with the Medical Center s values: Professionalism, Respect, Integrity, Diversity and Excellence, and provide guidance on how we communicate with patients, visitors, faculty, staff, and students, virtually everyone, every day and with every encounter. These standards include, but are not limited to: personal appearance, acknowledging and greeting all patients and families, introductions using AIDET, managing up, service recovery, managing delays and expectations, phone standards, electronic communication, team work, cultural sensitivity and competency.

* Uses effective communication skills with patients and staff; demonstrates proper telephone techniques and etiquette; acts as an escort to any patient or family member needing directions; shows sensitivity to differences of culture; demonstrates a positive and supportive manner in which patients / families/ colleagues perceive interactions as positive and supportive. Exhibits team work skills to positively acknowledge and recognize other colleagues, and uses personal experiences to model and teach Living PRIDE standards.

* Exhibits tact and professionalism in difficult situations according to PRIDE Values and Practices

* Demonstrates an understanding of and adheres to privacy, confidentiality, and security policies and procedures related to Protected Health Information (PHI) or other sensitive and personal information.

* Demonstrates an understanding of and adheres to safety and infection control policies and procedures.

* Assumes accountability for improving quality metrics associated with department/unit and meeting organizational/departmental targets.

Work Environment

* Keeps working areas neat, orderly and clutter-free, including the hallways. Adheres to cleaning processes and puts things back where they belong. Removes and reports broken equipment and furniture.

* Picks up and disposes of any litter found throughout entire facility.

* Posts flyers and posters in designated areas only; does not post on walls, doors or windows.

* Knows where the Environment of Care Manual is kept in department; corrects or reports unsafe conditions to the appropriate departments.

* Protects the physical environment and equipment from damage and theft.

Required Qualifications

* Minimum of three years experience working in a health care facility within the clinical environment

* 1- 2 years previous supervisory experience

* Degree in Healthcare and Registered Health Information Administrator (RHIA) or Registered Health Information Technician (RHIT) and Certified Coding Specialist (CCS)

* Three years coding in an acute care multi-facility teaching environment

* The ability to interpret and analyze coding data , reports and performance