Job Summary:

Healogics is the largest provider of advanced wound care services in the United States, treating more than 300,000 chronic wound patients annually across over 600 sites. With an aging society, obesity and diabetes on the rise, and an uptick in surgical procedures, the number of patients with non-healing wounds that would benefit from expert care is dramatically increasing. As a result, the company is working to provide our differentiated, quality outcomes to as many patients that would benefit through our out-patient clinic partnerships.

The Clinical Documentation Director, NPWT/DME will help to create, strategize, and administer Healogics Product Solutions programs. New product programs will ensure delivery of high-quality patient care, while reviewing medical necessity and medical record documentation reviews and audits. The Clinical Documentation Director will also perform other duties related to these primary functions.

All Healogics employees must perform their job responsibilities according to all Healogics policies, Hospital policies, as well as to accrediting organizations, federal and state regulation, and to the Centers for Medicare and Medicaid Services (CMS) guidelines, as applicable.

** This position is either located in Jacksonville, Florida, or can be remote. **

Essential Functions/Responsibilities:

• Reviews new product opportunities and creates implementation plans
• Manages the P&L for NPWT business including budgeting and forecasting
• Conducts various medical necessity and documentation reviews and audit using designated audit and review tools
• Maintains the documentation of clinical record audits and reviews in data software
• Assists in the preparation and presentation of clinical documentation monitoring/trending reports for review with physicians and leadership
• Participates in completion of special projects, as assigned
• Communicates with and updates leadership about assigned projects and audits
• Provides assistance and guidance to other team members and serves as a clinical resource/expert for NPWT/DME to the product solutions team
• Provides training and education of NPWT/DME LCD rules and guidelines to Healogics employees and practice professionals
• In person attendance at team meetings on a quarterly basis
• Performs other duties as required

Required Education, Experience and Credentials:

• ADN or ASN (Associate’s Degree in Nursing/Associate of Science in Nursing Degree) required; BSN (Bachelor’s in Nursing) preferred
• Current RN (Registered Nurse) or NP (Nurse Practitioner) license
• Minimum ten (10) years’ experience in nursing or in clinical auditing - or combination of equivalent experience
• Minimum five (5) years’ experience managing people, processes, or projects
• Experience working with a MAC (or predecessor), RAC, ZPIC or UPIC preferred
• Experience in wound care services or NPWT/DME preferred

Required Knowledge, Skills and Abilities:

• Working knowledge of ICD-10 coding preferred
• Demonstrated ability to review medical records using established criteria
• Working knowledge and understanding of billing, coding, and reimbursement regulations related to wound care or NPWT/DME, as well as of regulatory changes and payer updates - to be maintained for position.
• Working knowledge of latest NPWT/DME techniques and wound care coverage criteria
• Ability to work in fast paced environment and to work on multiple projects at the same time
• Ability to work with confidential materials and to maintain confidentiality
• Organization, prioritization and time management skills
• Strong analytical skills and problem-solving skills
• Strong attention to detail and accuracy
• Strong customer service skills
• Strong interpersonal, oral and written communication skills
• Ability to work with others and in a team environment
• Proficient in Microsoft Office (Excel, Word, Outlook) and SharePoint