Clinical Documentation Improvement Specialist - $5K Sign on Bonus - Sacramento, CAUnitedHealth Group - Sacramento, CA
Clinical Documentation Improvement Specialist - $5K Sign on Bonus - Sacramento, CA
For those who want to invent the future of health care, here's your opportunity. We're going beyond basic care to health programs integrated across the entire continuum of care. Join us and help people live healthier lives while doing your life's best work.(sm)
The Clinical Document Improvement Specialist
- (CDS) 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 the CDS oversight and practice is to assess 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 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.
In this position the CDS will utilizing the Optum CDI 3D technology that is assisting hospitals to improve data quality to accurately reflect the quality of care provided and ensure revenue integrity.
Our three-dimensional approach to CDI technology, paired with best-practice adoption methodology and change management support, is helping hospitals make a real impact on CDI efficiency and effectiveness.
Increase in identification of cases with CDI opportunities
, with automated review of 100% of records.
Improved tracking, transparency and reporting
related to CDI impact, revenue capture, trending and compliance.
Easing the transition to ICD-10
by improving the specificity and completeness of clinical documentation, resulting in more accurate coding.
This position does not have patient care duties, does not have direct patient interactions, and has no role relative to patient care.
Onsite position located at Mercy General Hospital in Sacramento, CA
Monday-Friday, daytime hours
Provides 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 condition and acuity of care provided
Conducts 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
Performs regular rounding with unit-based physicians and provides Working DRG lists to Care Coordination
Provides face-to-face educational opportunities with physicians on a daily basis
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
Provides timely feedback to providers regarding clinical documentation opportunities for improvement and successes
Ensures effective utilization of Midas or Optum ®
CDI 3D Technology to document all verbal, written, electronic clarification activity
Utilizes only the Optum360 approved clarification forms
Proactively develops a reciprocal relationship with the HIM Coding Professionals
Coordinates and conducts regular meeting with HIM Coding Professionals to reconsolidate DRGs, monitor retrospective query rates and discuss questions related to Coding and CDI
Engages and consults with Physician Advisor /VPMA 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
Current RN License with 5 years of acute care experience OR Medical School Graduate with Clinical Documentation Improvement experience
Experience communicating & working closely with Physicians
Basic proficiency using a PC in a Windows environment, including Microsoft Word, Excel, and Electronic Medical Records (Cerner is preferred)
2 years of Clinical Documentation Improvement experience
Current certification as a CCDS, CDIP or CCS
If RN, BSN degree
CAC experience (Computer Assistant Coding)
Cardiology experience a plus
Careers with Optum.
Here's the idea. We built an entire organization around one giant objective; make health care work better for everyone. So when it comes to how we use the world's large accumulation of health-related information, or guide health and lifestyle choices or manage pharmacy benefits for millions, our first goal is to leap beyond the status quo and uncover new ways to serve. Optum, part of the UnitedHealth Group family of businesses, brings together some of the greatest minds and most advanced ideas on where health care has to go in order to reach its fullest potential. For you, that means working on high performance teams against sophisticated challenges that matter. Optum, incredible ideas in one incredible company and a singular opportunity to do your life's best work.(sm)
Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity / Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.
UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.
Job Keywords: RN, Registered Nurse, CCDS, Certified Clinical Documentation Specialist, Quality Analyst, Quality Improvement Analyst, CDIP, ACDIS, Clinical Documentation Improvement Professional, CCS, Certified Coding Specialist, Doctor, Physician, Medical Graduate, CDI, California, Sacramento, Mercy General Hospital
Job Reference #:
17 days 10 hours ago
applyClinical Documentation Improvement Specialist - $5K Sign on Bonus - Sacramento, CA UnitedHealth Group - Sacramento, CA, United States
About UnitedHealth Group UnitedHealth Group is the most diversified health care company in the United States and a leader worldwide in helping people live healthier lives and helping to make the health system work better for everyone. We are committed to introducing innovative approaches, products and services that can improve personal health and promote healthier populations in local communities. Our core capabilities in clinical care resources, information and technology uniquely enable us to meet the evolving needs of a changing health care environment as millions more Americans enter a structured system of health benefits and we help build a stronger, higher quality health system that is sustainable for the long term
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