**Primary City/State:**
Arizona, Arizona
**Department Name:**
CDMP Documentation Team-Corp
**Work Shift:**
Day
**Job Category:**
Revenue Cycle
Great careers are built at Banner Health. There’s more to health care bedside doctors and nurses. We support all staff members as they find the path that’s right for them. Apply today, this could be the perfect opportunity for you.
The mission of the **Clinical Documentation Improvement Department** mission statement is to facilitate concise clinical documentation to appropriately reflect patient acuity, risk of mortality, and resource utilization in order to properly reflect patient care given and optimize organizational goals. The department is fully remote and promotes work/life balance. There are multiple avenues within the department for growth and development. The Banner CDI department is also active within the national Association for Clinical Documentation Integrity Specialists (ACDIS). The Banner Clinical Documentation Improvement (CDI) Department consists of a Senior Director, 4 Clinical Documentation Associate Directors, 1 Director of CDI Quality and Education, 2 CDI Educators, 3 CDI Auditors, and 70 Clinical Documentation Specialists.
**This fully** **Remote RN Clinical Auditor & Quality Review Specialist** **can reside in any Banner state** : **AK, AL, AR, AZ, CA, CO, FL, GA, IA, ID, IN, KS, KY, LA,** **MD,** **MI, MN, MO, MS, NC, ND, NE,** **NM,** **NV, NY, OH, OK, OR, PA, SC, TN, TX, UT, VA,** **WV,** **WA, WI & WY).** **We would prefer a state where there’s a physical Banner location** **AZ, C** **A, CO, NE, NV or WY.** With this remote work, candidates must be self-motivated, possess moderate to strong tech skills and be able to meet daily and weekly productivity metrics.
**Business hours are flexible Monday-Friday, 8 hour shifts** (generally between 7am – 7pm can work), with production being the greatest emphasis. No work on weekends or holidays.
Your pay and benefits (Total Rewards) are important components of your Journey at Banner Health. Banner Health offers a variety of benefit plans to help you and your family. We provide health and financial security options so you can focus on being the best at what you do and enjoying your life.
Within Banner Health Corporate, you will have the opportunity to apply your unique experience and expertise in support of a nationally-recognized healthcare leader. We offer stimulating and rewarding careers in a wide array of disciplines. Whether your background is in Human Resources, Finance, Information Technology, Legal, Managed Care Programs or Public Relations, you'll find many options for contributing to our award-winning patient care.
POSITION SUMMARY
This position is responsible for audit and analysis of clinical documentation improvement (CDI) staff chart reviews and queries. Provides education to CDI staff regarding opportunities for diagnosis clarification, principal diagnosis accuracy and improvement in capture of additional comorbid conditions. Perform concurrent and secondary clinical chart reviews for defined populations to identify opportunities to improve accuracy of provider documentation and resolve DRG discrepancies. Collect, analyze, and distribute data and information related to CDI audits and chart reviews. Works collaboratively with CDI leadership to ensure appropriate collection, management and reporting of data.
CORE FUNCTIONS
1. Performs routine audits on charts and clinical queries written by CDI staff to ensure compliance with query guidelines. Provides real-time performance feedback to staff on appropriateness and accuracy of queries and provides education, as needed, to correct workflow discrepancies. Tracks and monitors individual and group quality metrics and reports findings to CDI, HIMS and executive leadership.
2. Completes concurrent and secondary chart reviews of targeted patient populations to identify opportunities to improve accuracy of provider documentation, selection of diagnosis and procedure codes for accurate DRG assignment.
3. Analyzes and interprets clinical data to identify gaps, inconsistencies, and/or opportunities for improvement in the clinical documentation and appropriately queries the provider.
4. Regularly interacts with/educates physicians to enhance understanding of the CDI program and to ensure the medical record can be coded accurately in order to reflect patient severity of illness and risk of mortality.
5. Works with internal and external key stakeholders to identify and evaluate risk in all
areas of documentation improvement and works to establish, implement, and maintain a formalized review and audit process.
6. Collaborates on the development, implementation, and maintenance of standardized policies and procedures for data capture, analysis and retention; reporting of identified areas of risk, planning for data analyses and mitigation of issues.
7. Delivers CDI data insights that help drive strategic and tactical business opportunity and be a champion for a data-driven, decision-making culture. Drives organizational performance improvements by refinement and monitoring of the CDI scorecard and reconciliation process, which includes, but is not limited to: MS/APR DRG impact, agree rate, response rate, CDI coverage, query impact, etc. Participates in the improvement of processes and programs.
8. Prepares, analyzes, presents and disseminates performance reports for activities associated with the CDI program on an ongoing basis for enterprise, facility and department comparison. Provides support for vendor CAC/EHR products, which includes, but is not limited to: managing staff requests for enhancements, verifying functionality of updates, working with other vendors or BH teams to manage documents within the platforms.
9. This position is responsible for large scale, multi-facility, high risk projects across multiple departments system-wide and requires interaction at all levels of staff and management. Requires work in context of multiple commitments, priorities and conflicts. The incumbent functions in a fast-paced healthcare environment with a wide variety of healthcare programs, activities, and settings. This position is accountable for all resources within the areas of operational responsibility to ensure standards are exceeded for customer service, financial management and regulatory compliance. Internal customers include employees at all levels within the organization, including system leadership. External customers include vendors, providers and government entities.
MINIMUM QUALIFICATIONS
Requires a level of education as normally obtained through the completion of a bachelor’s degree in nursing, graduation from medical school or equivalent experience.
Requires Registered Nurse (R.N.) license in state worked.
Requires familiarity with AHIMA guidelines for compliant query practices and the ACDIS Code of Ethics. Requires functional knowledge on the use of computer assisted coding software. Requires a strong working knowledge of healthcare operations, medical/nursing staff procedures, clinical documentation and reimbursement methodologies as typically obtained through a minimum of three years relevant experience.
A working knowledge of software applications related to encoders, spreadsheets and word documents is required. Excellent organizational, human relations and communication skills are required to maintain good rapport and effective working relations with facility leaders, medical staff, nursing staff and other departmental personnel throughout the organization and external customers. Must also possess demonstrated skill in problem analysis, project management, conflict resolution and oral/written presentation.
PREFERRED QUALIFICATIONS
Certified Clinical Documentation Specialist, Certified Coding Specialist credential. Knowledge/use of Cerner.
Additional related education and/or experience preferred.
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Banner Health supports a drug-free work environment.
Banner Health complies with applicable federal and state laws and does not discriminate based on race, color, national origin, religion, sex, sexual orientation, gender identity or expression, age, or disability