You'll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges.
Primary 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
- Generally work is self-directed and not prescribed
- Works with less structured, more complex issues
- Serves as a resource to others
Required Qualifications
- Undergraduate degree or equivalent experience
- Current RN License or Medical School Graduate
- For RN: 3+ years acute inpatient CDI experience
- For Medical School Graduates: 2+ years of acute inpatient CDI experience
- Experience communicating & working closely with Physicians
- Experience performing concurrent inpatient chart reviews and physician query processes
- Experience working with ICD-10-CM/PCS documentation requirements
- Knowledge of inpatient reimbursement methodologies including MS-DRG and APR-DRG systems
- Knowledge of documentation regulations, compliant query practices, and coding guidelines
- Basic proficiency using a PC in a Windows environment, including Microsoft Word, Excel, and Electronic Medical Records
Preferred Qualifications
- If RN, BSN degree
- Current certification as a CCDS, CDIP or CCS
- Excellent verbal and written skills including solid organizational skills
*All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy
The salary for this role will range from $72,800 - $130,000 annually based on full-time employment.