Clinical Document Improvement (CDI) Specialist Manager

UnitedHealth Group • Honolulu, HI

8h • Onsite

About The Position

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. 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 review of the clinical documentation in the inpatient medical record of Optum 360 clients’ patients. The Manager, with the support of the CDI Director, is responsible for providing staff oversite, assisting with monthly reporting, and auditing, as well as mentoring and orientation of new staff. The Manager is responsible for attending client meetings and creating and delivering of staff and provider education to ensure that the documentation explicitly identifies all clinical findings and conditions present at the time of service.
This position collaborates with the 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.
This is an onsite position based out of Queen’s Medical Center, 1301 Punchbowl Street
Honolulu, Hawaii 96813

Requirements

• RN with current Hawaii RN license or obtain within 90-days of hire date or Foreign Medical Graduate with at least 3 years of CDI experience
• CCDS, CDIP or CCS certification
• Solid understanding of Microsoft, Word, Excel, and work related software
• Proven to be comfortable communicating & working closely with Physicians
• Proven excellent verbal and written skills including strong organizational skills
• Proven ability to multi-task
• Proven ability to lead teams
• Proven ability to present, speak in public

Nice To Haves

• BSN degree if an RN
• Experience in case management and / or critical care
• CDI Supervisor or Management experience
• Proven ability to lead projects with complex responsibilities and timelines

Responsibilities

• Assists CDI Director with chart audits, quality audit, and KPI audits
• Assists CDI Director with running reports, attends on site meetings as directed
• Oversees CDI staff training and orientation
• Oversees and leads workflow for CDI staff
• Ensures adequate staffing for the workload, and steps in to assist teams when workload is more than what the team can complete
• Develops physician teaching and on site presentations
• Assist CDI Director with projects or tasks as needed
• Timecard approval
• Coaching, performance management
• 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 oversees daily follow-up communication with providers regarding existing clarifications to obtain needed documentation specificity
• 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
• 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 CDI software, 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 to continually evaluate and spearhead clinical documentation improvement opportunities

Benefits

• a comprehensive benefits package
• incentive and recognition programs
• equity stock purchase
• 401k contribution

What This Job Offers

• Job Type: Full-time
• Career Level: Manager
• Education Level: No Education Listed