Associate Clinical Documentation Improvement Specialist

UnitedHealth Group; Plymouth (MN); À distance; USD 60 000 - 107 000; Plein temps

Résumé du poste

UnitedHealth Group is seeking a CDI Specialist to enhance clinical documentation integrity across acute care settings. The role emphasizes chart reviews, Medicare rule knowledge, and collaboration with physicians to ensure precise coding and quality care.

Applicants should have an Associates degree and either RN experience or CDI background, with strong clinical knowledge and EMR proficiency. This telecommuting position supports clinicians nationwide under UnitedHealth Group’s policy.

Qualifications

• Associates degree required; RN or medical grad with CDI experience preferred.
• Experience in acute care hospital settings and CDI processes essential.
• Advanced knowledge in clinical medicine, pathophysiology, and pharmacology.

Responsabilités

• Perform concurrent and retrospective chart reviews to improve clinical documentation.
• Stay updated on Medicare rules and diagnosis coding requirements.
• Provide leadership to improve documentation quality and communicate recommendations.

Connaissances

RN experience

CDI experience

Clinical medicine

Physician communication

MS Office / EMR

Formation

Associates degree

BSN preferred

CDS/CDIP/CCS certification

Outils

Electronic Medical Records

Windows PC

Description du poste

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’ll 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 maintains up to date knowledge of Medicare rules and regulations regarding diagnosis coding and CDI 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 review and assessment, and effectively articulating recommendations for improvement including the rationale 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 Technology to document all clarification activity
• Collaborates closely with interfacing departments such as Care Coordination and Quality
• Utilizes only the Optum/client approved clarification forms
• Proactively develops a reciprocal relationship with the HIM Coding Professionals
• Engages and consults with Physician Advisor/CMO when needed, per the hospital defined escalation process, to resolve provider issues regarding answering clarifications and participation in the clinical documentation integrity process

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.

Required Qualifications:

• Associates degree
• 5+ years 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 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 to $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.

Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.

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

#RPO, #GREEN