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

Valley Health System Consolidated Services; Las Vegas (NV); On-site; USD 95,000 - 140,000; Full time

Benefits offered by this job

Competitive compensation

Generous paid time off

Medical, dental, vision plans

401(k) with company match

Education and training center

Job summary

The Valley Health System is seeking a Regional CDI Manager to oversee the Clinical Documentation Integrity Program for GME and medical staff education in Southern Nevada. The role focuses on concurrent and retrospective reviews of inpatient records to ensure accurate documentation, appropriate coding, and compliant reimbursement for acute care services.

Ideal candidates hold an Associate’s in Nursing (Bachelor’s preferred) with 2+ years in acute care and 1+ year in CDI.

Qualifications

• Associate’s degree in nursing; bachelor’s degree preferred or graduate of a medical school.
• Two years of clinical experience in an acute care setting; 1 year CDI experience required.
• Domestic/International Medical Graduate: 1 year CDI experience; management experience preferred.
• Knowledge of Prospective Payment System and DRG assignment/optimization.

Responsibilities

• Manage day-to-day workflow of the CDI program for GME and medical staff education.
• Perform concurrent and retrospective reviews of inpatient records to evaluate accuracy of documentation and reimbursement.
• Report quality of care outcomes and ensure compliant reimbursement for acute care services.
• Communicate findings and provide physician documentation support to improve patient severity of illness and risk of mortality.

Skills

CDI knowledge

Clinical documentation integrity

Communication skills

EHR proficiency

Education

Associate’s degree in nursing

Bachelor’s degree in nursing preferred or medical degree

Tools

Electronic Health Records (EHR)

CDI/Coding software

Word processing

Databases & spreadsheets

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

At UHS and all our subsidiaries, our Human Resources departments and recruiters are here to help prospective candidates by matching skillset and experience with the best possible career path at UHS and our subsidiaries. We take pride in creating a highly efficient and best in class candidate experience. During the recruitment process, no recruiter or employee will request financial or personal information (Social Security Number, credit card or bank information, etc.) from you via email. The recruiters will not email you from a public webmail client like Hotmail, Gmail, Yahoo Mail, etc. If you are suspicious of a job posting or job-related email mentioning UHS or its subsidiaries, let us know by contacting us at: https://uhs.alertline.com or 1-800-852-3449.