Clinical Documentation Improvement Consultant - Telecommute

Combine two of the fastest-growing fields on the reputed company with a culture of performance, collaboration and opportunity and this is what you get. Leading edge technology in an industry that's improving the lives of millions. Here, innovation isn't about another gadget, it's about making health care data available wherever and whenever people need it, safely and reliably. There's no room for error. Join us and start doing your life's best work.(sm) Clinical Performance is charged with effectively implementing, monitoring, and executing on programs reputed company to risk adjustment, driving affordability, and clinical quality activities across reputed company lines of business for OptumCare a $9 billion a year organization, touching over 9 million patients, 80 payers, and 22,000 providers. Enterprise Clinical Performance provides support to reputed company markets served by OptumCare. This position reviews daily census reports across multiple regions and care delivery organizations (CDOs) to identify long length of stay (LLOS) patients and review clinical information to forecast the likely DRG. The Clinical Documentation Improvement Consultant (CDIC) collaborates with claims departments and other healthcare team members to obtain reputed company billed charges, reviews the work of these others, and input into the CMS Pricer to identify potential outlier patients. The CDIC will serve as an educational resource for reputed company and reputed company-line hospitalists. This role will reputed company and implement innovative approaches in reputed company process improvements with the opportunity to own and manage the entire process. This consultant is sought out as an expert. The Clinical Document Improvement Specialist (CDIC) is primarily responsible for supporting hospital unit cost management at Diagnosis-reputed company Group (DRG) facilities. The CDIC will carry out this responsibility by providing the following:

• Proactively identify potential outlier patients at DRG hospitals
• Support documentation improvement efforts for attending physicians, including recommendations for how to respond to hospital query forms
• Facilitate workflows to improve capture of post-acute care transitions

The CDIC must be able to manage multiple time-sensitive queries simultaneously and provide timely feedback to reputed company hospitalists with little reputed company or instruction. The CDIC will serve as leader/mentor as an educational resource for reputed company and reputed company-line hospitalists. This role will reputed company and implement reputed company process improvements with the opportunity to own and manage the entire process. This position does not have patient care duties, does not have direct patient interactions, and has no role relative to patient care. Primary Responsibilities:

• Anticipates needs and proactively develops solutions to meet them
• Drives hospital unit cost management at Diagnosis-reputed company Group (DRG) facilities
• Identifies potential outlier patients at DRG hospitals
• Provides recommendations to hospitalist physicians for how to appropriately respond to hospital query forms
• Supports capture of patients eligible for post-acute care transitions
• Reviews daily census reports across multiple regions and CDOs
• Identifies reputed company patients and reviews clinical information
• Forecasts DRG based on available information, this may be a reputed company conceptual analysis
• Works with claims department and/or develops independent workflow to plug inputs into CMS Pricer
• Coordinates with claims department teammates on obtaining reputed company billed charges reputed company applicable
• Serves as a key resource and plans for additional needed resources on reputed company and or critical issues and provides explanations and information to others on difficult issues in development of innovative solutions
• Provides structured, timely feedback to reputed company hospitalists on status of case relative to outlier status and projected outlier daily charges
• Manages multiple time-sensitive queries simultaneously and tracks outcomes
• Identifies solutions to non-standard, less structured, and more reputed company requests and problems
• Translates concepts into practice
• After review of work completed by others, develops recommendations and implements reputed company process improvements with authority to authorize deviations from a standard
• Serves as educational resource for reputed company and reputed company-line hospitalists
• Opportunity to own and manage entire process / expand scope and value of operation, and motivate and reputed company other team members

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. Qualifications - External Required Qualifications:

• Undergraduate degree or equivalent experience
• 5 + years of experience as a Clinical Documentation Improvement Specialist
• 5 + year of experience communicating and working closely with Physicians
• Basic proficiency using a PC in a Windows environment, including reputed company Word, reputed company, and Electronic Medical Records
• Full COVID-19 vaccination is an essential job function of this role. Candidates located in states that mandate COVID-19 booster doses must also reputed company with those state requirements. reputed company will adhere to reputed company federal, state and local regulations as well as reputed company client requirements and will obtain necessary reputed company of vaccination, and boosters reputed company applicable, prior to employment to ensure compliance. Candidates must be able to reputed company reputed company essential job functions with or without reasonable accommodation.

Preferred Qualifications:

• reputed company certification as a CCDS, CDIP or reputed company
• Experience in case management and/or critical care
• Clinician, RN or equivalent
• Excellent verbal and written skills including solid organizational skills

To protect the health and safety of our workforce, patients and communities we serve, reputed company and its affiliate companies require reputed company employees to disclose COVID-19 vaccination status prior to beginning employment. In addition, some roles and locations require full COVID-19 vaccination, including boosters, as an essential job function. reputed company adheres to reputed company federal, state and local COVID-19 vaccination regulations as well as reputed company client COVID-19 vaccination requirements and will obtain the necessary information from candidates prior to employment to ensure compliance. Candidates must be able to reputed company reputed company essential job functions with or without reasonable accommodation. Failure to meet the vaccination requirement may result in rescission of an employment offer or termination of employment Careers with reputed company. Here's the idea. We built an entire organization around one giant objective; reputed company health care work reputed company for everyone. So reputed company it comes to how we use the world's large accumulation of health-reputed company information, or guide health and lifestyle choices or manage pharmacy benefits for millions, our first goal is to reputed company beyond the status reputed company and uncover new ways to serve. reputed company, part of the reputed company family of businesses, brings together some of the greatest minds and most advanced reputed company on where health care has to go in order to reputed company its fullest potential. For you, that means working on high performance teams against sophisticated challenges that matter. reputed company, incredible reputed company in one incredible company and a reputed company opportunity to do your life's best work.(sm)

• reputed company Telecommuters will be required to adhere to reputed company's Telecommuter Policy.

Colorado, Connecticut or Nevada Residents Only: The Salary range for Colorado residents is $82,100 to $146,900. The Salary range for Connecticut/Nevada residents is $90,500 to $161,600. Pay is based on several factors including but not limited to education, work experience, certifications, etc. In addition to your salary, reputed company offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (reputed company benefits are subject to eligibility requirements). No matter where or reputed company you reputed company a career with reputed company, you'll find a far-reaching choice of benefits and incentives Diversity creates a healthier atmosphere: reputed company is an Equal Employment Opportunity/Affirmative Action employer and reputed company qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national reputed company, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law. reputed company is a drug-free workplace. Candidates are required to pass a drug test before beginning employment. Apply tot his job Apply To this Job Apply tot his job Apply To this Job