Associate Clinical Documentation Improvement Specialist

UnitedHealth Group; Glendale (CA); Remote; USD 60,000 - 107,000; Full time

Benefits offered by this job

Telecommuter policy

Job summary

UnitedHealth Group is seeking a CDI-focused professional to perform concurrent and retrospective chart reviews, ensuring complete and accurate clinical documentation and compliance with Medicare rules. You will guide documentation improvement and communicate findings to providers with clear rationale.

The role requires engaging with physicians and leveraging Optum CDI 3D Technology, with telecommuting flexibility across the U.S. and a strong focus on outcomes.

Qualifications

• Associate's degree required.
• 5+ years of acute care hospital clinical RN experience OR Medical Graduate with CDI experience.
• Advanced proficiency in clinical medicine, pathophysiology, and pharmacology.
• Advanced proficiency communicating & working closely with physicians.
• Intermediate proficiency with PC in Windows; Word, Excel, PowerPoint and Electronic Medical Records.

Responsibilities

• Perform concurrent and retrospective chart reviews for improving clinical documentation.
• Stay updated on Medicare rules and CDI trends.
• Use ICD-10 and related materials to investigate coding issues and produce accurate results.
• Communicate with providers to obtain documentation specificity.
• Lead efforts to improve clinical documentation and document rationale for recommendations.
• Engage with Physician Advisor/VPMA per escalation process.

Skills

CDI terminology

Physician communication

EMR proficiency

Documentation leadership

Education

Associate's degree

BSN preferred

CDI certifications (CCDS/CDIP/CCS)

Tools

EMR systems

Microsoft Word

Microsoft Excel

PowerPoint

Job description

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale.Join us to start Caring. Connecting. Growing together.

You will enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges.

Primary Responsibilities:

• Perform concurrent and retrospective chart reviews for improving the overall completeness of clinical documentation
• Keep abreast of current coding trends and maintain up to date knowledge of Medicare rules and regulations regarding diagnosis coding and CDI current trends
• Effectively utilizes ICD-10 and related materials to investigate coding issues and produce accurate results
• Conducts daily follow-up communication with providers regarding existing clarifications to obtain needed documentation specificity
• Provides expert level leadership for overall improvement in clinical documentation by providing proficient level review and assessment, and effectively articulating recommendations for improvement, and the rational for the recommendations
• Actively communicates with providers at all levels, to clarify information and to communicate documentation requirements for appropriate diagnoses based on severity of illness and risk of mortality
• Provides complete follow-through on all requests for clarification or recommendations for improvement
• Ensures effective utilization of Optum® CDI 3D Technology to document all clarification activities
• Utilizes only the Optum360 approved clarification forms
• Proactively develops a reciprocal relationship with the HIM Coding Professionals
• Engages and consults with Physician Advisor /VPMA when needed, per the escalation process, to resolve provider issues regarding answering clarifications and participation in the clinical documentation improvement process

You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear directions on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

Required Qualifications:

• Associate's degree
• 5+ years of acute care hospital clinical RN experience OR Medical Graduate with CDI experience
• Advanced level of proficiency in clinical medicine, pathophysiology, and pharmacology
• Advanced level of proficiency communicating & working closely with Physicians
• Intermediate level of proficiency using a PC in a Windows environment, including Microsoft Word, Excel, Power Point and Electronic Medical Records

Preferred Qualifications:

• 3+ years of CDI experience for an acute care hospital
• CCDS, CDIP or CCS certification
• BSN degree if a RN
• CAC experience (Computer Assistant Coding)

*All Telecommuters will be required to adhere to UnitedHealth Group's Telecommuter Policy.

Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $60,200 - $107,400 annually based on full-time employment. We comply with all minimum wage laws as applicable.

Pursuant to the San Francisco Fair Chance Ordinance, we will consider for employment qualified applicants with arrest and conviction records.

Application Deadline:This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.

At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location, and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups, and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission.

UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.

UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.

#RPO #GREEN