Clinical Document Integrity (CDI) Specialist Manager

Optum•Honolulu, HI

fulltime

Administrative

3+ years

About the role

Optum Insight is improving the flow of health data and information to create a more connected system. We remove friction and drive alignment between care providers and payers, and ultimately consumers. Our deep expertise in the industry and innovative technology empower us to help organizations reduce costs while improving risk management, quality and revenue growth. Ready to help us deliver results that improve lives? 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 Primary 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

You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

Required Qualifications

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 within 6 months of being in the role
Ability to be comfortable communicating & working closely with Physicians
Proven excellent verbal and written skills including solid organizational skills
Demonstrated solid understanding of Microsoft, Word, Excel, and work related software
Ability to multi-task
Ability to lead teams
Ability to present, speak in public

Preferred Qualifications

Experience in case management and / or critical care
CDI Supervisor or Management experience
Ability to lead projects with complex responsibilities and timelines

Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $91,700 to $163,700 annually based on full-time employment. We comply with all minimum wage laws as applicable.

At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission. UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations. UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.

Similar Opportunities

About Optum

Visit Website