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Careers at UnitedHealth Group

 

We have modest goals: Improve the lives of others. Change the landscape of health care forever. Leave the world a better place than we found it. Such aspirations tend to attract a certain type of person. Crazy talented. Compassionate. Driven. To these individuals, we offer the global reach, resources and can-do culture of a Fortune 5 company. We provide an environment where you’re empowered to be your best. We encourage you to take risks and in return, offer a world of rewards and benefits for performance. Exceeding your limits is an exceptional start to your life's best work.SM

 

Just like you, we are driven by a set of fundamental principles that are guiding our way forward. Our values of integrity, compassion, relationships, innovation, and performance serve as a foundation to transform health care. Are you in? Learn more about your future at UnitedHealth Group at careers.unitedhealthgroup.com

 

Job Category:

Nurse

Country:

United States

Postal Code:

11704

Approximate Salary:

Not Specified

Position Type:

Full Time

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Clinical Documentation Improvement Specialist - $5,000 Sign on Bonus For External Candidates - Bay Shore, NY

UHG - West Babylon, New York

Posted: 08/9/2018

For those who want to invent the future of health care, here's your opportunity. We're going beyond basic care to health programs integrated across the entire continuum of care. Join us and help people live healthier lives while doing your life's best work.(sm)   The Clinical RN Document Improvement Specialist - (CDS) is responsible for providing CDI program oversight and day to day CDI implementation of processes related to the concurrent review of the clinical documentation in the inpatient medical record of Optum 360 clients’ patients.  The goal of the CDS oversight and practice is to assess the technical accuracy, specificity, and completeness of provider clinical documentation, and to ensure that the documentation explicitly identifies all clinical findings and conditions present at the time of service. 
This position collaborates with providers and other healthcare team members to make improvements that result in accurate, comprehensive documentation that reflects completely, the clinical treatment, decisions, and diagnoses for the patient.  Utilizing clinical expertise and clinical documentation improvement practices and facility specific tools for best practice and compliance with the mission/philosophy, standards, goals and core values of Optum 360.  This position does not have patient care duties, does not have direct patient interactions, and has no role relative to patient care.   This is a Monday-Friday, days position located at Southside Hospital in Bay Shore, NY
Primary Responsibilities:

  • Provides expert level review of inpatient clinical records within 24-48 hours of admit; identifies gaps in clinical documentation that need clarification for accurate code assignment to ensure the documentation accurately reflects the severity of the patient condition and acuity of care provided
  • 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 level review and assessment, and effectively articulating recommendations for improvement, and the rational 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
  • Leads the development and execution of physician education strategies resulting in improved clinical documentation
  • Provides timely feedback to providers regarding clinical documentation opportunities for improvement and successes
  • Ensures effective utilization of the Midas Clinical Documentation Improvement Focus Study, documenting all verbal, written, electronic clarification activity
  • Utilizes only the facility/Optum 360 approved forms, whether paper or electronic
  • Steers the development and implementation of education plans for the interdisciplinary care team to promote accurate and complete documentation in the medical record
  • Proactively develops a reciprocal relationship with the HIM Coding Professionals
  • Coordinate and conducts regular meeting with HIM Coding Professionals to monitor retrospective query rate and address issues
  • Engages and consults with Physician Advisor when needed to resolve provider issues regarding answering clarifications and participation in the clinical documentation improvement process
  • Actively engages Case Management and RAC committee to continually evaluate and spearhead clinical documentation improvement opportunities to reduce denials and support medical necessity

 

$5,000 Sign on Bonus For External Candidates



Required Qualifications:
  • 5+ years of clinical experience working as an RN in an inpatient hospital, acute care setting OR Medical Graduate with CDI experience
  • Computer proficiency: recent working experience with Microsoft Outlook, Word, Excel and ability to navigate in a Windows based environment
  • Ability to interact with physicians and adapt communication style
  • Strong organizational skill
  • Effective verbal and written communication skills; ability to give presentations
Preferred Qualifications:
  • Coding experience
  • BSN/MSN degree
  • Previous CDI experience -  conducting efficient and regular documentation reviews and evaluating the quality and efficiency of documentation practice
  • Chart review experience
  • CDI Specialist Certification through ACDIS 
Health care isn't just changing. It's growing more complex every day. ICD10 replaces ICD9. Affordable Care adds new challenges and financial constraints. Where does it all lead? Hospitals and health care organizations continue to adapt, and we are a vital part of their evolution. And that's what fueled these exciting new opportunities.
Optum360 is a dynamic new partnership formed to exemplify our unique expertise. As part of the growing family of UnitedHealth Group, we'll leverage all our resources to bring financial clarity and a full suite of revenue management services to health care providers nationwide.If you're looking for a better place to use your passion and your desire to drive change, this is the place to be. It's an opportunity to do your life's best work.(sm)   **PLEASE NOTE** The sign on bonus is only available to external candidates. Candidates who are currently working for a UnitedHealth Group, UnitedHealthcare or a related entity in a full time, part time, or per diem basis ("Internal Candidates") are not eligible to receive a sign on bonus.     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.
    Key Words: ICD 10, coding, RN, Registered Nurse, Nurse, case management, critical care, BSN, clinical documentation improvement, CDIP, CCDS, CCS,  CDI, DRG, chart review, Northwell,  Bay Shore, NY, New York

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