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At UConn Health,the Clinical Documentation Improvement an Quality Manager is responsible for planning, directing, coordinating, evaluating, and supervising the staff engaged in the quality of care reviews on all services, compliance with policies, regulatory guidelines,high quality and production standards accuracy, and resolution of coding discrepancies.
COMPREHENSIVE BENEFITS OFFERED:
Industry-leading health insurance options and affordability
Generous vacation and sick-time plans
Multi-channel retirement options (pension and match options)
Tuition waiver and reimbursement for employees and qualified family members
Quick commute access from I-84, Rte 9 and surrounding areas
State of the art facility and campus environments
Progressive leadership and educational development programs available
- Plans and directs unit workflow and determines priorities; schedules, assigns, oversees and reviews the work of staff; provides staff training and assistance; conducts performance evaluations; establishes and maintains unit procedures;
- Acts as liaison with operating units, agencies and outside officials regarding unit policies and procedures. Develops, assists and makes recommendations with related policies or standards; and prepares reports and correspondence as needed.
- Ensures monthly production and key metrics are met and provides coaching as needed;
- Collaborates with the CDI Physician Champion and Coding Manager to resolve DRG coding and documentation discrepancies, clinical disparities education and training needs for physicians, CDI and Coding staff;
- Identifies opportunities for improvement by studying the variances form policies and practices. Prepares reports to leadership as opportunities for improvement.
- Monitors documentation and coding of staff for compliance and regulatory standards; identifies variances from practice and policy and opportunities for improvement;
- Participates in and contributes to organizational and departmental initiatives and performance improvement projects.
- Keeps abreast of changing trends, regulations and technology related to documentation, coding, and reimbursements;
- Collaborate with interdisciplinary teams including, but not limited to, denials management, Utilization management, Quality and Case Management.
- Assists with strengthening technical coding practices and Clinical Documentation by reviewing patient records with flagged complications (i.e., patient Safety Indicators (PSI) to ensure that coding accurately reflects the patient's clinical course and complexity for accurate risk adjustment used in government incentive/penalty programs
- Performs related duties as required.
KNOWLEDGE, SKILL AND ABILITY:
Considerable knowledge of applicable regulatory guidelines;
Considerable knowledge of third party documentation standards and regulatory guidelines;
Considerable knowledge of quality assurance and process improvement measures related to documentation;
Knowledge of the nursing process and complex disease processes;
Advanced clinical expertise in an acute care, inpatient setting;
Knowledge of insurance company reimbursement principles, CPT, ICD-CM/PCS, and DRG coding;
Knowledge of coding and documentation procedures applicable to various specialties;
Considerable interpersonal skills; oral and written communication skills;
Proficient computer skills to include Microsoft office suite;
Ability to analyze, develop and present high level analysis and metrics;
Supervisory ability.
General Experience:
Bachelor's or Master's degree in Nursing, or equivalent degree in HIM field with CDI experience
Registered Nurse and either three (3) years of medical/surgical/critical care experience in an acute care or clinical practice or three (3) years utilization/clinical case management experience in a hospital setting; and
Three (3) years of experience in Clinical Documentation Improvement/integrity.
Must possess and maintain licensure as a Registered Nurse in the State of Connecticut;
Certification as a Certified Clinical Documentation Specialist (CCDS) through the Association of Clinical Documentation Integrity Specialists (ACDIS), or as a Certified Documentation Improvement Practitioner (CDIP) through the American Health Information Management Association (AHIMA). If not certified at time of hire, must obtain certification within one (1) year of employment in the role.
Why UConn Health
