CDI Quality Liaison

Mass General Brigham•Somerville, MA

2d•Remote

About The Position

The Clinical Documentation Integrity (CDI) Quality Liaison is responsible for oversight and development of CDI processes focused on improving the capture of the high-quality care delivered at MGB. Under direct supervision of the Manager, CDI Quality, the CDI Quality Liaison will develop strategies to critically review records for appropriate clinical documentation related to quality indicators and outcomes including, but not limited to, Elixhauser and Vizient comorbidities, Patient Safety Indicators (PSIs) and Hospital Acquired Conditions (HACs). The CDI Quality Liaison will have a deep understanding of the nature of quality reporting and how clinical documentation affects these areas. The CDI Quality Liaison will work closely with the Coding and Quality departments to adhere to a pre-bill reconciliation process and facilitate collaboration to enable a clinical focus on identified quality initiatives.

Requirements

Associate's Degree required
Registered Nurse with a current license required
5 years of acute medical/surgical care nursing required
3 - 5 years of clinical documentation improvement experience, quality management, or related roles in a healthcare setting
Familiarity with hospital coding practices, quality reporting systems, and regulatory standards (e.g., CMS, Joint Commission).
Strong understanding of clinical documentation requirements and quality care metrics.
Proficient in data analysis and report generation to track quality outcomes and documentation accuracy.
Attention to detail with the ability to identify documentation gaps and implement corrective actions.
Strong organizational skills with the ability to manage multiple tasks and meet deadlines.
Demonstrate a thorough knowledge of hospital quality measures, reporting, and the impact of CDI on quality outcomes
Demonstrate a clear understanding of clinical and operational workflows within a CDI program
Maintain a high proficiency and understanding of CDI initiatives encompassing basic through advanced CDI knowledge and skills
Demonstrate a thorough understanding of regulatory compliance associated with CDI
Basic knowledge of ICD-10 coding/classification systems appropriate for the inpatient prospective payment system
Ability to analyze and interpret data to strategically drive efforts for improved outcomes
Possess strong people skills to effectively communicate with cross functional teams, including clinical and non-clinical staff at all levels of the organization
Self-directed and motivated to function both independently and collaboratively
Ability to successfully negotiate and collaborate with others of different skill sets, backgrounds and levels within and external to the organization
Strong problem solving and negotiation skills
Ability to effectively conduct meetings, both formal and informal
Requires minimal direction from leadership and possesses the ability to learn quickly

Nice To Haves

Certification in Clinical Documentation preferred
Academic Medical Center experience preferred
2 - 3 years of experience with quality metrics, regulatory compliance, and clinical documentation processes preferred

Responsibilities

Perform CDI mortality reviews post coding and prebill
Develop strategies to critically review records for appropriate clinical documentation related to quality indicators and outcomes including, but not limited to, Elixhauser and Vizient comorbidities, Patient Safety Indicators (PSIs) and Hospital Acquired Conditions (HACs)
Promote improvement initiatives directed at system-wide quality indicators (i.e., PSIs, HACs) and clinical evidence to support appropriate DRG, principal diagnosis, and secondary diagnoses assignments
Develop and lead implementation of pre-bill reconciliation process for encounters that require clinical documentation improvement intervention related to quality measures and reporting
Provide ongoing monitoring and support for pre-bill reconciliation process
Serve as CDI Quality subject matter expert staying current with AHRQ Quality Indicator specifications, CMS value-based care programs, U.S. News and World Report, Vizient and other quality reporting programs as needed
Assist with education and training for clinical and non-clinical staff across the MGB system around CDI-related quality initiatives and topics as needed
Support the analysis, tracking, trending, and reporting of CDI related quality initiatives
Issue clinically credible and compliant queries to providers as appropriate with focus on addressing organizational quality initiatives
Accurately interpret clinical information in the health record, evaluating clinical indicators to identify potential diagnoses and query opportunity
Communicate appropriately and compliantly, either verbally, in writing, or by email with providers and/or members of the clinical team to improve health record documentation
Work collectively with RCO Coding Specialists and/or Quality team as related to supporting clinical documentation efforts to accurately reflect the quality of care being delivered at MGB
Meet with the physician advisors, as needed
Maintain professional competency by keeping abreast of clinical advancements and coding guidelines on a yearly basis. Ongoing review of professional and coding literature.
Use the Mass General Brigham values to govern decisions, actions and behaviors. These values guide how we get our work done: Patients, Affordability, Accountability & Service Commitment, Decisiveness, Innovation & Thoughtful Risk; and how we treat each other: Diversity & Inclusion, Integrity & Respect, Learning, Continuous Improvement & Personal Growth, Teamwork & Collaboration
Other duties as assigned