1+ months

Clinical Documentation Improvement Specialist - Full-time Onsite Phoenix AZ - 924064

Phoenix, AZ 85003
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  • Job Code
    924064

Health care isn't just changing. It's growing more complex every day. ICD10 replaces ICD9. Affordable Care adds new challenges and financial constraints. Where does it all lead? Hospitals and health care organizations continue to adapt, and we are a vital part of their evolution. And that's what fueled these exciting new opportunities. Optum360 is a dynamic new partnership formed by Dignity Health and Optum to combine our unique expertise. As part of the growing family of UnitedHealth Group, we'll leverage all our resources to bring financial clarity and a full suite of revenue management services to health care providers nationwide. If you're looking for a better place to use your passion and your desire to drive change, this is the place to be. It's an opportunity to do your life's best work.(sm)

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Primary Responsibilities:

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  • Provides expert level review of inpatient clinical records within 24-48 hours of admit; identifies gaps in clinical documentation that need clarification for accurate code assignment to ensure the documentation accurately reflects the severity of the condition and acuity of care provided
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  • Conducts daily follow-up communication with providers regarding existing clarifications to obtain needed documentation specificity
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  • Provides expert level leadership for overall improvement in clinical documentation by providing proficient level review and assessment, and effectively articulating recommendations for improvement, and the rational for the recommendations
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  • Actively communicates with providers at all levels, to clarify information and to communicate documentation requirements for appropriate diagnoses based on severity of illness and risk of mortality
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  • Performs regular rounding with unit-based physicians and provides Working DRG lists to Care Coordination
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  • Provides face-to-face educational opportunities with physicians on a daily basis. Provides complete follow through on all requests for clarification or recommendations for improvement
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  • Leads the development and execution of physician education strategies resulting in improved clinical documentation
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  • Provides timely feedback to providers regarding clinical documentation opportunities for improvement and successes
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  • Ensures effective utilization of Midas or Optum CDI 3D Technology to document all verbal, written, electronic clarification activity
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  • Utilizes only the Optum360 approved clarification forms
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  • Proactively develops a reciprocal relationship with the HIM Coding Professionals
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  • Coordinates and conducts regular meeting with HIM Coding Professionals to reconsolidate DRGs, monitor retrospective query rates and discuss questions related to Coding and CDI
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  • Engages and consults with Physician Advisor /VPMA when needed, per the escalation process, to resolve provider issues regarding answering clarifications and participation in the clinical documentation improvement process
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  • Actively engages with Care Coordination and the Quality Management teams to continually evaluate and spearhead clinical documentation improvement opportunities
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Youll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

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Required Qualifications:

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  • Education in Nursing with a board approved nursing program with a passing score on the National Council Licensure Exam (NCLEX) or State Board Test Pool Exam (SBTPE) with 2+ years of acute care experience OR
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  • Current RN license in any state with at least 2 years of acute care experience OR
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  • Medical School Graduate with at least one year of CDI experience OR
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  • RHIT or RHIA with a CCS with at least 2 years of inpatient coding experience
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  • Previous experience as a Clinical Documentation Integrity Specialist
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  • Experience communicating & working closely with Physicians
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  • Basic proficiency using a PC in a Windows environment, including Microsoft Word, Excel, and Electronic Medical Records (Cerner is preferred)
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  • Excellent verbal and written skills including strong organizational skills
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  • You will be asked to perform this role in an office setting or other company location
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  • Employees are required to screen for symptoms using the ProtectWell mobile app, Interactive VoiceResponse (i.e., entering your symptoms via phone system) or a similar UnitedHealth Group approved symptom screener prior to entering the work site each day, in order to keep our work sites safe. Employees must comply with any state and local masking orders. In addition, when in a UnitedHealth Group building, employees are expected to wear a mask in areas where physical distancing cannot be attained
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Preferred Qualifications:

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  • Previous experience in case management and / or critical care
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  • Current certification as a CCDS, CDIP or CCS
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Optum360 is a dynamic new partnership formed by Dignity Health and Optum to combine our unique expertise. As part of the growing family of UnitedHealth Group, we'll leverage all our resources to bring financial clarity and a full suite of revenue management services to health care providers nationwide.

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If you're looking for a better place to use your passion and your desire to drive change, this is the place to be. It's an opportunity to do your life's best work (sm)

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"Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.

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UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.

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Job Keywords: clinical, specialist, improvement, healthcare, technology, Optum360, Phoenix, AZ, Arizona

Posted: 2021-04-13 Expires: 2021-07-11

UnitedHealth Group is the most diversified health care company in the United States and a leader worldwide in helping people live healthier lives and helping to make the health system work better for everyone.

Sponsored by:
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Clinical Documentation Improvement Specialist - Full-time Onsite Phoenix AZ - 924064

UnitedHealth Group
Phoenix, AZ 85003

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