CDI Manager - Onsite - Chandler, AZ

UnitedHealth Group•Chandler, AZ

4d•$91,700 - $163,700•Onsite

About The Position

Optum Insight is improving the flow of health data and information to create a more connected system. We remove friction and drive alignment between care providers and payers, and ultimately consumers. Our deep expertise in the industry and innovative technology empower us to help organizations reduce costs while improving risk management, quality and revenue growth. Ready to help us deliver results that improve lives? Join us to start Caring. Connecting. Growing together. The Clinical Document Improvement Specialist Manager - is responsible for providing CDI program oversight and day to day CDI implementation of processes related to the concurrent review of the clinical documentation in the inpatient medical record of Optum 360 clients’ patients. The goal of LCDS oversight and practice is to support the CDI manager function by providing staff oversite, serve as an additional resource as well as perform CDI role function. The Manager will assure via assessment, and teaching staff and providers the technical accuracy, specificity, and completeness of provider clinical documentation, and to ensure that the documentation explicitly identifies all clinical findings and conditions present at the time of service. This position collaborates with CDI Director, providers and other healthcare team members to make improvements that result in accurate, comprehensive documentation that reflects completely, the clinical treatment, decisions, and diagnoses for the patient. The CDS utilizes clinical expertise and clinical documentation improvement practices as well as facility specific tools for best practice and compliance with the mission/philosophy, standards, goals and core values of Optum 360. This position does not have patient care duties, does not have direct patient interactions, and has no role relative to patient care. Travel is required between facilities and may be required for meetings at other facilities

Requirements

5+ years of acute care hospital clinical RN experience OR Medical Graduate with CDI experience and CDI certification (CCDS, CDIP)
2+ years of experience communicating & presenting to Physicians
Proficiency using a PC in a Windows environment, including Microsoft Word, Excel, Power Point and Electronic Medical Records
Ability to work in Chandler, AZ

Nice To Haves

CCDS, CDIP or CCS certification
People management experience
Experience in Clinical Documentation Improvement
CAC experience (Computer Assistant Coding)

Responsibilities

Conducts chart audits, quality audit and KPI audits
Conducts CDI Manager with running reports, attends on site meetings as directed
Oversees CDI staff training and orientation
Overseas and leads workflow for CDI staff
Develops physician teaching and on-site presentations
Assist CDI Director with projects or tasks as needed
Timecard approval
Coaching
Evaluations
Other duties as assigned
Communicates performance expectation of leadership to staff level CDI staff
Oversee that CDI staff are providing 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 patient condition and acuity of care provided
Ensures and oversee daily follow-up communication with providers regarding existing clarifications to obtain needed documentation specifically
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
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
Performs regular rounding with unit-based physicians
Provides face-to-face educational opportunities with physicians.
Provides complete follow-through on all requests for clarification or recommendations for improvement
Leads the development and execution of physician education strategies resulting in improved clinical documentation
Ensures timely feedback to providers regarding clinical documentation opportunities for improvement and successes
Ensures effective utilization of the CAC tool, ensuring documentation of all verbal, written, electronic clarification activity
Utilizes only the Optum360 approved forms, whether paper or electronic
Proactively develops a reciprocal relationship with the HIM Coding Professionals
Coordinate and conduct regular meetings with HIM Coding Professionals to monitor retrospective query rate and address issues
Engages and consults with Physician Advisor when needed, per the escalation process, to resolve provider issues regarding answering clarifications and participation in the clinical documentation improvement process
Actively engages with Care Coordination and the Quality Management teams