Healthcare CDI Audit & Quality Lead

Datavant; Madison (WI); Presencial; USD 50.000 - 58.000; Jornada completa

Ventajas ofrecidas por este puesto de trabajo

Health insurance

Dental insurance

Vision insurance

401k with match

Paid time off

Floating holidays

Flexible work arrangements

Career growth opportunities

Descripción de la vacante

Datavant is seeking a Clinical Documentation Quality Improvement (CDQI) Audit Specialist in Madison, WI to evaluate the quality, accuracy, and compliance of CDI reviews and identify opportunities for education and process improvement that enhance revenue integrity and patient care.

You will conduct retrospective and concurrent audits of CDIQ Specialists, provide feedback and education plans, onboard new staff, deliver presentations, monitor performance metrics, and uphold HIPAA/privacy standards

Formación

• 5+ years of CDI experience and/or auditing.
• 3+ years of clinical experience in an academic medical center.
• RN or BSN with CCDS or CDIP certification.
• Must pass CDI skills competency assessment.
• Experience with various EMRs and CDI software including Epic, Cerner, 3M, Iodine, etc.
• Strong organizational, teamwork and communication skills.

Responsabilidades

• Conduct retrospective and concurrent audits of CDIQ Specialists work to ensure accurate documentation review practices, compliant query generation, assess appropriate capture of: SOI, ROM, CC/MCC, HCC, and align with coding, quality and regulatory requirements.
• Review missed opportunities impacting reimbursement, quality reporting and patient outcomes. Collaborate with physicians and caregivers to ensure appropriate reimbursement and clinical severity for DRG-based payer patients.
• Evaluate CDQI staff adherence to organizational workflows, policies and industry standards.
• Maintain audit tools, scoring methodologies, and audit documentation
• Provide individualized feedback to CDQI Specialists and develop education plans based on audit findings.
• Participate in onboarding and mentoring new CDQI staff.
• Deliver educational presentations on documentation, coding, regulatory updates and best practices.
• Collaborate with Physician Advisor regarding documentation opportunities and trends.
• Monitor program performance indicators, including query rates, query response rates, agreement rates, accuracy scores, case mix index impact and CC/MCC capture rates.
• Maintain confidentiality and safeguard PHI, medical records, audit documentation, and company data in compliance with HIPAA, organizational policies, and regulatory requirements.
• Meet or exceed established production, quality, and performance metrics by completing assigned audits within designated timeframes and maintaining high standards of accuracy, consistency, and objectivity. Produce clear, actionable audit findings and educational feedback that support CDI staff development and program improvement

Conocimientos

CDI auditing

Clinical experience

Communication skills

Organization

Educación

RN/BSN with CCDS/CDIP

Herramientas

Epic

Cerner

3M CDI

Iodine

Descripción del empleo

Datavant is seeking a Clinical Documentation Quality Improvement (CDQI) Audit Specialist in Madison, WI to evaluate the quality, accuracy, and compliance of CDI reviews and identify opportunities for education and process improvement that enhance revenue integrity and patient care.

You will conduct retrospective and concurrent audits of CDIQ Specialists, provide feedback and education plans, onboard new staff, deliver presentations, monitor performance metrics, and uphold HIPAA/privacy standards