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Providence Health & Services Regional Clinical Documentation Integrity Educator in Los Angeles, California

Description:

Providence St. Joseph Health is calling a Regional Clinical Documentation Integrity Educator to our location in Los Angeles, CA.

We are seeking a Regional Clinical Documentation Integrity Educator to be responsible for supporting and facilitating the overall quality improvement process of the medical record documentation by improving the completeness of clinical documentation. The primary goal will be to work directly with educating the CDI teams to engage staff in increasing their knowledge and understanding of ICD-9/ICD-10 documentation requirements, query opportunities, provider relationship building, clinical concepts, industry best practices, auditing outcomes and identify further development opportunities. With ICD-9/ICD-10 content expertise, works directly mentoring the CDI teams and collaborates with the Clinical Coders and the Provider Specialist to obtain appropriate the appropriate clinical documentation, positively affecting outcomes. Reports to CDI leadership team on metrics associated with current documentation risks, trends and opportunities. The Regional CDI Educator exercises independent judgment and discretion within agreed upon limitations and takes actions as needed based on knowledge of the organization, its policies, procedures, and personnel.

In this position you will have the following responsibilities:

  • Assists in monitoring of monthly reports, identifying trends and educating CDI staff on possible opportunities to improve workflow, DRG, CC/MCC capture, RAC targets and O/E Mortality ratios. Ensures that local CDI staff is in compliance with System standards, adhering to policy and procedures.

  • Utilize metrics to track and review trends for targeted education and opportunities for CDI team to improve query structure and process.

  • Providing on-site support and education enhancement on ICD-9/ICD-10 to the CDI team, customizing education curriculum for new and experienced staff to ensure CDI foundational knowledge is established or enhanced.

  • Primary responsibilities include developing standardized ICD-9/ICD-10 compliant queries for the CDI program and provide clinical feedback to clinical coding team (CDI and Coders).

  • Increase effectiveness of CDI-Coder interactions through dynamic reconciliation discussions, exchanging tips from Coding Guidelines/Clinics, identifying CDI and coder query opportunities.

  • Demonstrates knowledge of documentation requirements and guidelines in accordance with Coding Clinic and SJHS compliance. Facilitates modification to clinical documentation to ensure that overall quality and appropriate reimbursement is received for the level of service rendered to all patients independent of payer.

  • Maintains positive open communication with local CDI staff, interdisciplinary care team members and their department managers and regional Provider Specialists.

  • Collaborate with Provider Specialist exchanging trends in opportunities to improve CDI query practice and provider educational focus. Work in concurrence with the Corporate Physician Advisor to advance the system’s clinical documentation integrity program.

Qualifications:

Required qualifications for this position include:

  • Associate of Science Degree in Nursing.

  • 2 years recent experience in the acute hospital setting (focused on engaging providers, understanding clinical documentation and coding concepts).

  • 2 – 5 years of CDI experience.

  • Strong clinical background and ability to engage CDI staff and coders one-on-one or in group settings.

  • Background with educating CDI staff on the documentation nuances and differences between coding and clinical language.

  • Current California RN Nursing License.

Preferred qualifications for this position include:

  • Bachelor of Science degree in Nursing, healthcare administration or other related field.

  • Recent experience with multi-site responsibility for CDI/coder training and education as software super-user/resource.

  • Experience with multi-site impact and outcomes validation and reporting for CDI programs with development of educational opportunities for CDI and coder teams based on ICD-9/10 coding, corroborating CDI-coder DRG assignments.

  • 1 year experience with system-wide CDI education/training for best practice, compliance and workflows including multidisciplinary team processes for CDI/Coders, including performing a CDI workflow assessment.

  • Experience with monitoring and auditing enterprise CDI programs for educational/growth opportunities of CDI staff development/best practice.

  • Experience working with site team leaders for software use and maintenance of CDI program required to assure accuracy in reporting outcomes.

  • Analytical skills, ability to interpret data, and generate reports from 3M CDIS and the ROC tool, overall turning valuable data into presentable information.

  • Knowledge of ICD-10 and its impact on providers and CDI staff practices.

  • Certified Clinical Documentation Specialists (CCDS) or Clinical Documentation Improvement Professional (CDIP) credentials.

About the department you will serve.

Providence Strategic and Management Services provides a variety of functional and system support services for all eight regions of Providence St. Joseph health from Alaska to California. We are focused on supporting our Mission by delivering a robust foundation of services and sharing of specialized expertise.

We offer a full comprehensive range of benefits - see our website for details

http://www.providenceiscalling.jobs/rewards-benefits/

Our Mission

As expressions of God’s healing love, witnessed through the ministry of Jesus, we are steadfast in serving all, especially those who are poor and vulnerable.

About Us

Providence Health & Services is a not-for-profit Catholic network of hospitals, care centers, health plans, physicians, clinics, home health care and services guided by a Mission of caring the Sisters of Providence began over 160 years ago. Providence is proud to be an Equal Opportunity Employer. Providence does not discriminate on the basis of race, color, gender, disability, veteran, military status, religion, age, creed, national origin, sexual identity or expression, sexual orientation, marital status, genetic information, or any other basis prohibited by local, state, or federal law.

Schedule: Full-time

Shift: Day

Job Category: Administrative (Clinical)

Location: California-Los Angeles

Other Location(s): California-Torrance, California-Burbank

Req ID: 225090

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