LEAD CLINICAL DOCUMENTATION COORD/GME - VALLEY HOSPITAL (FULL-TIME)

Spring Valley Hospital; Las Vegas (NV); Hybrid; USD 90,000 - 130,000; Full time

Benefits offered by this job

Competitive pay

Paid time off

Medical, dental, vision plans

401(k) with company match

Career opportunities

Job summary

The Valley Health System is seeking a CDI Manager to oversee the Clinical Documentation Integrity program for GME and medical staff education. The role involves concurrent and retrospective review of inpatient records to ensure documentation accurately reflects severity of illness and risk of mortality.

Responsibilities include coordinating with external payers and regulators, reporting quality outcomes, and ensuring compliant reimbursement for acute care services.

Qualifications

• RN with 2+ years in acute care; 1+ year CDI experience
• Knowledge of PPS and DRG processes
• Strong communication and critical thinking skills
• Experience with EHR and CDI/coding software

Responsibilities

• Oversee day-to-day CDI program operations for GME and medical staff education
• Conduct concurrent and retrospective review of inpatient records to evaluate utilization and documentation
• Ensure accurate reflection of severity of illness and risk of mortality in documentation
• Coordinate with payers and regulators and report quality of care outcomes
• Support compliant reimbursement for acute care services

Skills

CDI experience

PPS knowledge

Critical thinking

Verbal/written communication

Education

Associate’s degree in nursing

Bachelor’s degree in nursing preferred

Graduate of a domestic/international medical school

Tools

Electronic Health Records

CDI/Coding software

Job description

Responsibilities

The Valley Health System has expanded into an integrated health network that serves more than two million people in Southern Nevada. Starting with Valley Hospital Medical Center in 1979, the Valley Health System has grown to include Centennial Hills Hospital Medical Center, Spring Valley Hospital Medical Center, Summerlin Hospital Medical Center, Henderson Hospital, Valley Health Specialty Hospital, and West Henderson Hospital.

Benefit Highlights:

• Competitive Compensation & Generous Paid Time Off
• Excellent Medical, Dental, Vision and Prescription Drug Plans
• 401(K) with company match and discounted stock plan
• Career opportunities within VHS and UHS Subsidies
• Challenging and rewarding work environment
• Comprehensive education and training center

Job Description

Under the supervision of the Regional Manager CDI manages day-to-day workflow, specifically the operations of the Clinical Documentation Integrity Program for GME and medical staff education.
This position is also responsible for providing clinically based concurrent and retrospective review of inpatient medical records to evaluate the utilization and documentation of acute care services. The goal of concurrent review includes facilitation of appropriate physician documentation of care delivered to accurately reflect patient severity of illness and risk of mortality. Specific reviews are determined both internally and by requirements/requests of external payers or regulatory agencies and play a significant role in reporting quality of care outcomes and in obtaining accurate and compliant reimbursement for acute care services.

Qualifications

Education: Associate’s degree in nursing; bachelor’s degree in nursing preferred or a Graduate of a domestic/international school of medicine.

Experience: For Registered Nurse, a minimum of two (2) years of clinical experience in an acute care setting (critical care, surgical or emergency department nursing preferred), and a minimum of 1-year previous clinical documentation integrity experience (2-3 years of previous clinical documentation integrity experience preferred). Knowledge of the Prospective Payment System and Diagnosis Related Group selection, assignment and optimization are required.
For Domestic/International Medical Graduate: A minimum of 1-year previous clinical documentation integrity experience (2-3 years of previous clinical documentation integrity experience preferred). Knowledge of the Prospective Payment System and Diagnosis Related Group selection, assignment and optimization are required. Minimum of 1-year management experience strongly preferred but not required.

Technical Skills: Computer proficiency to include word processing, databases, and spreadsheets. Familiarity with the operation of basic office equipment. Basic competence in use of electronic health records and other CDI/Coding software applications.
License/Certification: If Registered Nurse, current RN license in their state of residence.
Preferred certifications: CDIP, CCDS, CCS and/or ICD-10 Certification or Trainer designation.

Other: Strong broad-based clinical knowledge and understanding of pathology/physiology of disease processes. Knowledge of age-specific needs and elements of disease processes and related procedures required. Working knowledge of inpatient admission criteria.

Medicare reimbursement system and coding systems required. Must possess excellent written and verbal communication skills and critical thinking skills. Ability to work independently in a time-oriented environment is essential.

EEO Statement

All UHS subsidiaries are committed to providing an environment of mutual respect where equal employment opportunities are available to all applicants and teammates. UHS subsidiaries are equal opportunity employers and as such, openly support and fully commit to recruitment, selection, placement, promotion and compensation of individuals without regard to race, color, religion, age, sex (including pregnancy, gender identity, and sexual orientation), genetic information, national origin, disability status, protected veteran status or any other characteristic protected by federal, state or local laws.

We believe that diversity and inclusion among our teammates is critical to our success.

Notice

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