HEALTH INFORMATION MANAGEMENT DIRECTOR

Position Summary

The HIM Manager is responsible for the successful maintenance, integrity, and accessibility of all inpatient and outpatient medical records. This position oversees operational aspects of the HIM department and serves as the facility resource regarding medical record content and regulatory requirements. The HIM Manager ensures compliance with facility policies and procedures, CMS regulations, Joint Commission standards, QAPI requirements, and all federal and state confidentiality laws.

Essential Responsibilities

• Create and maintain the Master Patient Index
• Supervise documentation, retrieval, storage, and record integrity processes
• Ensure timely completion and deficiency tracking of all medical records
• Respond to medical record requests (including legal/court requests) in compliance with HIPAA and state law
• Submit discharge records to RHIA coder within 24 hours
• Produce daily census reports and SBS reports for leadership
• Conduct chart audits using QAPI tools
• Prepare reports for Medical Staff Meetings
• Submit required regulatory and QAPI data
• Maintain payor mix analysis reports
• Facilitate education and training on documentation standards and CMS chart requirements
• Participate in OPPE/FPPE processes
• Maintain awareness of regulatory updates and accreditation changes

Qualifications

• High School Diploma required; additional training in Health Information Management required (RHIT, RHIA, or equivalent certification strongly preferred)
• Minimum 5 years of HIM leadership experience or equivalent role
• At least 1 year of supervisory experience
• Psychiatric hospital HIM experience preferred

Knowledge & Skills

• Working knowledge of ICD-10 and CPT coding
• Understanding of psychiatric diagnoses and documentation requirements
• Strong regulatory knowledge (CMS, Joint Commission, HIPAA)
• Strong analytical and problem-solving skills
• Proficiency with EMR systems, computers, tablets, and mobile tools
• Strong organizational and communication skills

Certifications & Requirements

• Valid Photo ID
• Social Security Card / Driver’s License
• Primary Source Verification of Education
• CPR Certification
• Behavioral Management Training
• Annual TB Screening

Work Environment & Physical Requirements

• Exempt leadership position
• Moderate-to-high activity level
• Standing/walking up to 60–80% of shift
• Ability to lift/carry 10+ pounds
• Exposure Category II (potential exposure to blood/bodily fluids)
• Psychiatric acute care setting