WE ARE HIRING!
Location: 550 S. Jackson Street Louisville,KY 40202 

About UofL Health 
UofL Health is a fully integrated regional academic health system with nine hospitals, four medical centers, Brown Cancer Center, Eye Institute, nearly 200 physician practice locations, and more than 1,000 providers in Louisville and the surrounding counties, including southern Indiana. Additional access to UofL Health is provided through a partnership with Carroll County Memorial Hospital.  Affiliated with the University of Louisville School of Medicine, UofL Health is committed to providing patients with access to the most advanced care available. This includes clinical trials, collaboration on research and the development of new technologies to both save and improve lives. With more than 13,000 team members – physicians, surgeons, nurses, pharmacists and other highly-skilled health care professionals, UofL Health is focused on one mission: to transform the health of communities we serve through compassionate, innovative, patient-centered care. For more information on UofL Health, go to www.uoflhealth.org.

Job Summary:

This position is responsible for conducting ongoing audit and analysis of clinical documentation, Perform analytical assessment of data, data manipulation, report data outcomes and CDI impact to the organization. Perform initial and ongoing training for the HIM CDIS team, physicians, and other departments, as necessary. Initiate and onboard orientation of new Clinical Documentation Specialists and CDI Ambassadors. Ensure compliance with clinical documentation improvement standards, coding guidelines and HIM policies and procedures. Responsible for designing, conducting, facilitating system-wide CDI educational coding and documentation training to include, Providers, Residents (as applicable), and CDI Specialists. Works with CDI Manager to develop and maintain current training materials and conduct on-going training to physicians as coding guidelines, rules, and regulations change. Will conduct focused, specialty-specific documentation quality audits and utilize data to develop educational plans and drive clinical key performance indicator (KPI) outcomes. Identifies areas of risk and assists in developing and implementing processes to minimize or eliminate risks. Performs concurrent medical record reviews and queries accounts appropriately utilizing CDI workflow/tools as assigned. Actively participates in department and hospital performance initiatives when needed to ensure the overall UofL Health success.

• Oversee and assign the daily work assignments.
• Review quality and production standards of CDI staff making sure monthly key metrics are met and provide coaching as needed.
• Conducts pre-bill coding and clinical documentation audit and analysis to optimize missed opportunities.
• Serves as superuser for 3M 360 Encompass clinical documentation improvement application.
• Develops and presents education to Healthcare Providers to keep them up to date in documentation principles and concepts relative to their areas of practice.
• Performs concurrent and retrospective physician query audits to ensure compliance with industry standards regarding compliant clinical query best practices.
• Makes recommendations for process improvements to further enhance clinical documentation improvement quality goals and outcomes.
• Performs concurrent and retrospective analysis of CDI KPI metrics, develop outcomes reports and identify opportunities with quality standards.
• Performs CDI concurrent and retrospective second-level review audits to identify potential gaps in clinical documentation and DRG assignment validation for specified facility, patient types, and payer populations.
• Conducts internal audits of the CDI process to identify areas of improvement and develop plans for training and education.
• Collaborate with CDI manager to identify and resolve key findings of needed improvement.

• Remains abreast of CDI Best Practice standards and support the mission, vision and values of the HIM CDI program.
• Develops materials for provider educational presentations, tip sheets, pocket cards and other tools as needed.
• Develops clinical documentation improvement workflow education materials and job aides to facilitate system-wide new hire, department orientation and continuing CDI education and staff development training.
• Maintains compliance with all company policies, procedures and standards of conduct.
• Complies with HIPAA privacy and security requirements to maintain confidentiality at all times.
• Performs other duties as assigned

Education:
• RN, LPN, MD, RHIT. (required)

Experience:
• 3-5 years Clinical Documentation Integrity experience in an acute care facility (required)
• Minimum of 3 years clinical experience in an acute care setting (required)
• Previous electronic medical record and chart review experience (required)
• Prior experience with Cerner PowerChart and 3M 360 Encompass (preferred)
• Minimum of 2 years leadership experience in an acute care setting (preferred)

Licensure:
• Active Kentucky Nurse License or compact license with privileges to work in Kentucky (required)

Certification:
• AHIMA CDIP or ACDIS CDIS certification required upon hire or within 12 months (required)
• AHIMA CCS or AAPC CIC certified coding credential (preferred)