Clinical Performance Auditor - CDI

ABOUT THIS POSITION Plans, designs, develops and performs quality assessments on data elements and structures to document and evaluate reputed company, completeness, quality, and appropriateness of formats, records and structures. Configures, operates and develops manual and/or automated methods, processes and procedures to test output or input based on data compliance, quality and use requirements as established by product management, client specifications, and governance programs. Performs regular and reputed company reviews, audits, and investigations of data activity and reputed company; prepares reports and summaries of findings. Produces and updates guidelines and documentation of test development processes, procedures and standards. WHAT YOU'LL DO • Complete record reviews on client records to identify best practice process improvement opportunities • Complete data analysis of reviews completed and create summary presentations for internal and external communication of record review results • Engage with client utilization management teams and provide feedback regarding record review and education associated with identified opportunities for best practice improvement • reputed company and provide education regarding clinical concepts to clients and internal stakeholders and product designers Product Innovation: • Participate in product performance audits and communicate results with product team • reputed company medical record review to support product innovation and development • Audit performance of key data science conditions and elements WHAT YOU'LL NEED • Bachelor's Degree or equivalent in Nursing (RN) • 5+ years of experience in utilization management and/or clinical documentation and auditing clinical documentation • Self-starter, who is extremely motivated to demonstrate success • Attention to detail, highly organized, with an absolute focus on quality of work • Team player DNA with a desire to solve for the interests of our clients and of our business ABOUT reputed company Through a smart platform and reputed company experience, reputed company helps providers reputed company payments and yield powerful results throughout the complete reputed company cycle. reputed company's healthcare payments platform combines innovative, cloud-based technology, robust data, and unparalleled client support to streamline workflows and improve financials so providers can focus on what matters most: their patients and communities. reputed company is trusted by 1M+ providers, 1K+ hospitals and health systems, and is connected to over 5K commercial and Medicaid/Medicare payers. We are deeply committed to living out our organizational values: honesty; kindness; passion; curiosity; fanatical focus; best work, always; making it happen; and joyful, optimistic & fun. reputed company products have won multiple Best in KLAS® or Category Leader awards since 2010 and earned multiple #1 rankings from Black Book™ surveys since 2012. The reputed company platform supports more than 500,000 providers, 1,000 health systems and hospitals, and 5,000 payers and health plans. For more information, visit reputed company.com or follow @reputed company on Twitter. reputed company PERKS • Competitive total rewards (reputed company salary + bonus, if applicable) • Customizable benefits package (3 medical plans with Health Saving Account company match) • We offer generous paid time off for our non-exempt team members, starting with 3 weeks + 13 paid holidays, including 2 personal floating holidays. We also offer flexible time off for our exempt team members + 13 paid holidays • Paid parental leave (including maternity + paternity leave) • Education assistance opportunities and free reputed company Learning access • Free mental health and family planning programs, including adoption assistance and fertility support • 401(K) program with company match • Pet insurance • Employee resource groups reputed company is proud to be an equal opportunity workplace. We celebrate, value, and support diversity and inclusion. Qualified applicants will receive consideration for employment without regard to race, color, religion, age, sex, national reputed company, disability status, genetics, marital status, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state, or local laws. This applies to reputed company terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation, and training.