Regional Director of Health Information Management (HIM) & HIPAA/Privacy Officer
STAR Medical Auditing Services LLC
**This position is based in Hawaii on the Island of Kauai and the successful candidate must be willing to relocate. Financial assistance will be provided for relocation.**
STAR Medical Auditing Services is looking for a full-time Regional Health Information Management Director for a client located in Hawaii.
The Regional Director of Health Information Management & HIPAA/Privacy Officer is responsible for planning, organizing, overseeing, and following up on all activities related to the HIM department and the integrity of clinical and financial data. They oversee coding quality and data integrity; ensures that documentation and coding practices meet national coding and compliance guidelines; provides coder and physician education on proper documentation procedures; and oversee all coding and documentation audits. The Regional Director of HIM must have a working knowledge of the “International Classification of Diseases Manual” (among other manuals) and serve as liaisons between clinical and administrative professionals in the hospital and its affiliates. They are the regional custodian of the legal medical record. This position also serves as the HIPAA/Privacy Officer who oversees all activities including the development, implementation, and maintenance of all policy and procedures to assure compliance with the Health Insurance Portability and Accountability Act of 1996. This position may be required to work shifts, weekends, holidays, and requires travel to all facilities within the region.
This position reports to Regional Chief Financial Officer (RCFO).
Administrative Role 60%
- Implement processes and systems to ensure accurate and complete medical record documentation.
- Oversees the clinical documentation improvement program and works with the clinical documentation. specialist and physicians to improve the quality of documentation.
- Oversee coding staff to ensure accurate coding for reimbursement and clinical care.
- Ensure compliance with state and federal laws and standards related to privacy, security, and record completion and reporting.
- Track and trend audits and denials from third-party payers and auditors.
- Prepare and analyze clinical data for research purposes, process improvement, utilization management, and mandatory reporting.
- Ensures HIM department and hospital policies and procedures comply with requirements of CMS, Joint Commission, Medical Staff Bylaws, Rules and Regulations, and other regulatory agencies as applicable.
- Ensures the integrity, completeness, and accuracy of medical records.
- Plans, implements, and monitors quality and production of department functions to best support patient care and hospital needs.
- Ensures HIM operations are executed in an effective and efficient manner to perform within established budget and KPI targets.
- Oversees the abstracting, transcription, and release of information processes to ensure continuity of care, privacy and confidentiality and compliance with regulatory agencies.
- Oversees the development, implementation, maintenance of, and adherence to privacy policies and procedures regarding the safe use and handling of protected health information (PHI) in compliance with federal and state HIPAA regulations.
- Manages all activities related to data and statistics for internal and external reporting of delinquencies, physician suspension, and other metrics.
- Prepares departmental budget reports and participates in strategic planning as needed.
- Prepares responses to and recommendations from the Department of Health, CMS, TJC, and other agencies regarding HIM issues and represents the organization in court cases involving subpoenas of medical or clinical records, utilizing knowledge of principles of medical jurisprudence and Hawaii State laws governing use of clinical records in court action.
- Performs Continuous Improvement Activities in the areas of:
- Quality care review and medical record studies such as Medical Records Monitoring, Medical Care Evaluation studies, Utilization Review studies and other medical staff review activities.
- Reporting and monitoring development such as morbidity, birth, death, and DRG.
- Documentation, communication, eHealth implementation, EHR infrastructure, and policy issues covering all aspects of the HIM department.
Supervisory Functions 20%
- Provides general and direct supervision of all HIM staff: Coders, Health Information Techs, and Clinical Documentation Specialist.
- Attends internal and external meetings including staff meetings, medical and other meetings with state or federal agencies.
- Establishes work productivity and performance standards for employees under immediate supervision, rates their job performance, and discusses rating with employees.
- Provides coaching when deemed necessary to improve performance.
- Provides counseling, documentation, and corrective action as guided by the policy and procedures of staff who are unable to meet job/performance standards.
- Reviews, investigates, and resolves personnel problems through the use of collective bargaining provisions and personnel rules and regulations and takes appropriate disciplinary action as needed.
- Develops criteria in accordance with the ideal employee standards and participates as the chair or panel member in the interview process.
- Enhances professional growth and development through trainings, seminars, conferences, etc.
- Follows, implements, and enforces policies and procedures with patients, employees, and visitors.
Customer Experience/Communication 15%
- Establishes individual and departmental performance standards (benchmarks) to achieve customer service and fiscal performance measures.
- Serves as a role model by displaying, maintaining, and encouraging professional behavior at all times; demonstrates, promotes, and encourages positive, professional customer relations with patients, visitors, physicians, and coworkers.
- Maintains effective, customer-focused communication with staff, physicians, other departments, and healthcare providers. Collaborates with HIM Supervisors to ensure that medical record issues and complaints are addressed professionally, timely, and effectively.
- Provides teaching/training for new orientees and ongoing training for all staff members. Updates and monitors staff competencies as appropriate.
- Performs frequent communication: procedures/policies, performance improvement reports, memos, evaluations, and teaching programs.
- Promotes the hospital, organizational goals, initiatives, and changes in a positive, proactive manner.
- Provides leadership, guidance, and directions in implementing hospital guidelines for customer service.
- Maintains a line of positive communication, promotes teamwork by promoting professional collaboration at all levels.
Other Functions 5%
- Conducts and documents routine staff meetings, and participates in the short and long-range planning initiatives.
- Consistently maintains good working relationships with other units throughout the region and outside stakeholders in the community.
- Maintains and develops professional growth through seminars, conferences, etc.
- Maintains the strictest confidentiality of all regional and affiliated employees and/or patient information.
- Performs other duties as assigned by the Regional Chief Executive Officer.
Experience: At least 5 years of professional HIM work experience with strong background in performing qualitative and qualitative analysis and technical evaluation of clinical records; coordinate and integrate medical records; abstracting; coding; and reference work for clinical research projects. 5 years’ experience with managerial and leadership experience and proven track record in building and developing high-performance teams.
Certification: Registered Health Information Administrator (RHIA) required; must be current and in good standing through AHIMA.
Additional Skills: Knowledge of administrative functions, principles, procedures, and practices of health information management; fundamentals of medical science; fundamentals of human anatomy and physiology; medical terminology; current trends and developments in health information management methods and procedures; pertinent federal, state and local medical record reporting requirements and laws affecting medical care activities; hospital procedures, medical ethics and customs; and uses and limitations of primary and secondary records, indexes and classification systems.
Ability to supervise and direct the operations of a health information management department; apply principles and practices of health information management; analyze medical data from clinical records; prepare plans, policies, guidelines, standards and procedures relating to health information management activities; ability to provide health information management consultative services; and ability to conduct seminars and training sessions in health information management activities; compile statistical reports; and deal tactfully and effectively with others.
Certification as a Certified Coding Specialist (CCS or CCS-P) preferred.
Bachelor’s degree in Health Information Management from a college or university accredited by the AHIMA or a Bachelor’s degree from an accredited college or university and a certificate in Health Information Administration from an accredited program.
Eligible employees have a choice of health insurance plans – medical, dental, drug, and vision with no waiting period.
PTO consists of 13 paid holidays per year (14 during an election year), up to 21 days of sick leave and 21 days of vacation leave each year. Vacation and sick leave are accrued on a monthly basis.
This is an HGEA union position. Lower salary range is eligible for ERSA retirement; upper salary range is management and will have a 401K that they can contribute to.
Instructions for Resume Submission:
Email resumes and cover letters to STAR Medical Auditing Services, attention Monique Modelo, HR Specialist, and Robyn Petersen, CEO.
Or apply online at the website listed below.
Apply Online: https://www.starauditing.com