Vacancy expired!
Employment Type:Full timeShift:Day ShiftDescription:Remote Work Eligible PositionPOSITION PURPOSEAt the direction of the Regional Manager and Supervisor, Clinical Documentation Integrity (CDI), this position is responsible for implementation and ongoing activities of the CDI quality and compliance plan for the Health Ministries (HMs) within their region.Performs quality reviews as outlined in the CDI quality plan, such as by Clinical Documentation Specialist (CDS), service line, focus area and as otherwise necessary to ensure quality, completeness and accuracy of health record documentation. Develops CDS education based on results of quality reviews of queries, audit results, and regulatory changes. Provides a high-level of technical competency and serves as a subject matter expert regarding documentation, compliant queries, coding, billing, reimbursement and compliance management as it relates to CDI. Assists with denials management, complex case resolution and may perform CDI reviews as directed.Provides CDS support via phone or written communications, including in-services and other user group forums. Provides direction for daily review assignments and operations. Responsible for developing and maintaining systems training and process documentation. Assists with training and on-boarding of new CDS colleagues. Prepares standard education for clinicians.Works closely with Clinicians, Coding, Quality and Denials teams to facilitate documentation within the medical record and supports the patient’s severity of illness, risk of mortality, clinical validity and proper DRG assignment.ESSENTIAL FUNCTIONSMaintains current knowledge of the MS-DRG system, CCs/MCCs, impact on quality, risk of mortality, severity of illness and CMI as well as ICD-10 coding systems and the guidelines related to Clinical Documentation Integrity.Provides direction for daily review assignments and workflow.Develops and maintains an expert level working knowledge of CDystems, policies, and processes, training courses, materials and certification exercises.Designs and develops training and education programs that align with end-user needs for components of CDI systems and processes.Coordinates provision of training programs and functions as the trainer/facilitator of CDI training programs. Trains and on-boards new CDS colleagues.Provides user support through phone coverage, written updates and communications, user forums and other available tools and methods.Conducts quality reviews and reports findings to Regional Supervisor and Regional Manager on a routine basis.Serves as the technical resource for CDI systems support, testing and training.Designs, develops and delivers effective educational programs, informational materials and workflow tools that assists the Regional CDI Leadership with integrating compliance into their operations and improving processes and skills.Communicates with and educates physicians and all members of the healthcare team regarding clinical documentation and monitors provider participation. Designs, develops and delivers standard clinician education.Maintains superuser level skill set in the use of 3M/360 and leverages technology and system reporting to improve CDI team efficiency and effectiveness. Monitors the CDI Dashboard and reporting to identify opportunities for improvement and areas of focus.May perform CDI reviews to support program during high volume, short staffing periods.Maintains a working knowledge of applicable Federal, State, and local laws and regulations, Trinity Health Corporate Integrity Program, Code of Ethics, as well as other policies and procedures in order to ensure adherence in a manner that reflects honest, ethical, and professional behavior.Hourly pay range: $40.6207 - $60.9311MINIMUM QUALIFICATIONSAssociate degree in Health Information Technology, Healthcare related field or Nursing or equivalent in experience.Must possess one of the below:
Current Registered Nurse (RN) License
Registered Health Information Administrator (RHIA)
Registered Health Information Technician (RHIT)
Certified Coding Specialists (CCS)
Licensure as a physician assistant (PA) or Nurse Practitioner/Advanced Practice Nurse (NP/APN) or completion of medical school
Certified Clinical Documentation Specialists (CCDS) or Certified Documentation Improvement Professional (CDIP) preferred.Minimum of three years of current hospital clinical documentation integrity program experience is required.Must have thorough knowledge of CMS regulations, coding guidelines and DRG reimbursement.Demonstrated knowledge of state and federal Hospital Acquired Conditions (HAC) and other applicable quality indicator codes (i.e., PSI, PPI, etc.).Demonstrated, current expertise with 3M CDI Software. Working knowledge of Epic EMR preferred. Analytical ability and skill to effectively and efficiently resolve a broad range of clinical documentation integrity issues. Critical thinking skills and the ability to work independently with minimal supervision, organize work and set priorities.Interpersonal skills necessary to effectively interact with the CDI and coding teams, patients, medical staff, other health ministry departments and any outside agencies.Intermediate computer skills required, including working knowledge of and experience using MS Word, Excel, Outlook and PowerPoint. Must be able to spend majority of work time utilizing a computer, monitor and keyboard.Maintains professional attitude and ability to relate well with leadership, physicians, other care providers, colleagues and patients and others within the scope of the position.Strong understanding of the Catholic health ministry in an evolving health care delivery system and changing reimbursement market.Personal presence that is characterized by a sense of honesty, integrity, and caring as well as the ability to inspire and to motivate others to promote the philosophy, mission, vision, goals, and values of the Ministry.PHYSICAL AND MENTAL REQUIREMENTS AND WORKING CONDITIONSAbility to work in a fast-paced, multi-customer environment, with conflicting needs. May warrant varied and/or extended hours, with changes in workload and priorities to keep pace with the industry and advanced strategic priorities.Must possess the ability to comply with enterprise policies and procedures.Must be able to spend majority of work time utilizing a computer, monitor and keyboard.The above statements are intended to describe the general nature and level of work being performed by persons assigned to this classification. They are not to be construed as an exhaustive list of duties so assigned.Our Commitment to Diversity and InclusionTrinity Health is one of the largest not-for-profit, Catholic healthcare systems in the nation. Built on the foundation of our Mission and Core Values, we integrate diversity, equity, and inclusion in all that we do. Our colleagues have different lived experiences, customs, abilities, and talents. Together, we become our best selves. A diverse and inclusive workforce provides the most accessible and equitable care for those we serve. Trinity Health is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, status as a protected veteran, or any other status protected by law.Our Commitment to Diversity and InclusionTrinity Health is a family of 115,000 colleagues and nearly 26,000 physicians and clinicians across 25 states. Because we serve diverse populations, our colleagues are trained to recognize the cultural beliefs, values, traditions, language preferences, and health practices of the communities that we serve and to apply that knowledge to produce positive health outcomes. We also recognize that each of us has a different way of thinking and perceiving our world and that these differences often lead to innovative solutions.Our dedication to diversity includes a unified workforce (through training and education, recruitment, retention, and development), commitment and accountability, communication, community partnerships, and supplier diversity.EOE including disability/veteran
Vacancy expired!