Nurse Claims Analyst
ZipLiens
Director II, Clinical Documentation
Ensemble Health Partners
full-time
Posted on:
Origin: • 🇺🇸 United States
Visit company websiteJob Level
Lead
Tech Stack
Unity
About the role
- By embodying our core purpose of customer obsession, new ideas, and driving innovation, and delivering excellence, you will help ensure that every touchpoint is meaningful and contributes to our mission of redefining the possible in healthcare. This position encompasses all administrative and clinical functions that contribute to the capture, management, and collection of a successful Clinical Documentation Integrity (CDI) program. Performs CDI program evaluation, inpatient documentation review, training, and shadowing client counterparts. Uses CDI concepts to educate and engage hospital designated staff on the requirements for ICD-10 reimbursement implications, trending, and quality impact. Project management, client management, solution design and implementation and generation of engagement results. Guide the client through transformation efforts for continuous improvement using change management strategies. Auditing: Conducting thorough audits to assess compliance and identify areas for improvement. Training: Developing and delivering comprehensive training programs for staff to enhance their understanding of clinical documentation practices. Quality and Productivity: Monitoring and evaluating the quality and productivity of documentation processes to ensure optimal performance. Policies and Procedures: Assisting in the creation and enhancement of policies and standard operating procedures for clinical documentation improvement programs. Compliance: Ensuring adherence to guidelines set forth by the organization, government, and relevant regulatory bodies. Knowledge Maintenance: Staying current with all federal and state coding and documentation guidelines to ensure compliance and best practices are consistently applied. Data Analysis: Evaluating and analyzing statistical data, maintaining databases and spreadsheets, and utilizing related software to produce analytical reports. Feedback and Action Plans: Providing constructive feedback and developing actionable plans to implement improvements when necessary. Goal Development: Assisting in the development of organizational Clinical Documentation Integrity (CDI) specific goals and objectives, as well as performance improvement processes. Relationship Building: Building and maintaining productive inter- and intra-departmental relationships, as well as vendor partnerships, to optimize operations and enhance collaboration. Strategic Oversight: Developing and monitoring strategic operating goals, objectives, and budget. Reporting on operational performance, providing justifications, and implementing corrective actions as needed. Educational Needs Monitoring: Continuously assessing ongoing educational needs based on regulatory changes and areas identified through quality audits. Resource for DRG Information: Serving as a key resource for Physicians, Client Leadership, Quality, and other professional staff regarding published Diagnosis-Related Group (DRG) information. Associate Management: Developing and managing direct reports while overseeing the development and management of indirect reports. This document is not an exhaustive list of all responsibilities, skills, duties, requirements, or working conditions associated with the job. Associates may be required to perform other job related duties as required by their supervisor, subject to reasonable accommodation.
Requirements
- Registered Nurse (RN) ONE CERTIFICATION PER FIELD CCDS CRCR Or other approved job relevant certification. Bachelors Degree or Equivalent Experience Nursing Other Preferred Preferred Minimum Education - Specialty/Major: Nursing degree required, Master's Degree Nsg or Business desirable Minimum Years and Type of Experience: Minimum 5 years clinical nursing experience, preferably in Med/Surg, Critical Care, Intensive Care or the Emergency Department At least three years of Clinical Documentation Improvement experience. This position requires willingness to travel frequently for Ensemble business needs; ability to communicate with essential staff for business purposes with a variety of healthcare professionals, revenue cycle leadership, and organizational leadership. Highly organized, detail oriented, strategic thinking, self-motivated, can articulate and present information in a professional and concise manner and revenue cycle experience.
