Clinical Documentation Improvement Specialist

UnitedHealth Group • Los Angeles, CA

286d • $71,600 - $140,600 • Remote

About The Position

Optum Home & Community Care, part of the UnitedHealth Group family of businesses, is creating something new in health care. We are uniting industry-leading solutions to build an integrated care model that holistically addresses an individual's physical, mental and social needs - helping patients access and navigate care anytime and anywhere. As a team member of our naviHealth product, we help change the way health care is delivered from hospital to home supporting patients transitioning across care settings. This life-changing work helps give older adults more days at home. We're connecting care to create a seamless health journey for patients across care settings. Join us to start Caring. Connecting. Growing together. The Clinical Documentation Improvement Specialist (CDI Specialist) is responsible for completing daily concurrent documentation reviews to ensure the consistency and accuracy of physician documentation. The goal of the CDI Specialist's role is to assess, review, and provide relevant feedback to reinforce physician education. This position collaborates with health care team members to ensure consistent, evidence-based clinical guidelines are being followed and reflected accurately in clinical documentation. The CDI Specialist utilizes expertise and clinical documentation improvement practices as well as program-specific tools to ensure best practices and compliance with the mission/philosophy, standards, goals and core values of Optum Health. You'll enjoy the flexibility to work remotely from anywhere within the U.S. as you take on some tough challenges.

Requirements

• Current RN License or Medical School Graduate
• For RN: 3+ years CDI experience
• For Medical School Graduates: 2+ years of CDI experience
• Experience communicating & working closely with Physicians
• Basic proficiency using a PC in a Windows environment, including Microsoft Word, Excel, and Electronic Medical Records

Nice To Haves

• If RN, BSN degree
• Current certification as a CCDS, CDIP or CCS
• 5+ years CDI experience
• Proven excellent verbal and written skills including solid organizational skills

Responsibilities

• Provides expert level review of clinical records within 24-48 hours of admission; reviews clinical documentation to ensure consistency and alignment with evidence-based guidelines
• Conducts clear communication to providers to reinforce evidence-based guidelines are being followed
• Effectively tracks productivity to allow for accurate/timely reporting of leading indicators and future impact analyses
• 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 rationale for the recommendations
• Provides educational opportunities for physicians and other health care team members
• Provides complete follow through on all requests for clarification or recommendations for improvement
• Participates in the development and execution of education strategies resulting in improved clinical documentation
• Provides timely feedback to providers regarding clinical documentation opportunities for improvement and successes
• Engages and consults with Medical Director/leadership when needed, per the escalation process, to resolve 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

• Comprehensive benefits package
• Incentive and recognition programs
• Equity stock purchase
• 401k contribution

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Industry: Insurance Carriers and Related Activities
• Education Level: Bachelor's degree