CDI Quality Analyst
%3Cp class=%22MsoHeader%22%3E%3Cspan style=%22font-family:Arial, Helvetica, sans-serif;font-size:12px;%22%3EThe Clinical Documentation Improvement (CDI) program at UI Health Care has an opening for a full-time %3Cstrong%3ECDI%3C/strong%3E %3C/span%3E%3Cspan style=%22background-color:white;color:black;font-family:Arial, Helvetica, sans-serif;font-size:12px;%22%3E%3Cspan style=%22mso-color-alt:windowtext;%22%3E%3Cstrong%3EQuality Analyst%3C/strong%3E%3C/span%3E%3C/span%3E%3Cspan style=%22font-family:Arial, Helvetica, sans-serif;font-size:12px;%22%3E. The primary purpose of Clinical Documentation Improvement (CDI) is concurrent review of the medical record to increase the accuracy, clarity, and specificity of provider documentation (Association of Clinical Documentation Improvement Specialists, ACDIS). The %3Cstrong%3ECDI Quality Analyst %3C/strong%3Ebridges the gap between the providers and hospital coders to clarify at-risk documentation to ensure accurate claim submission (American Health Information Management Association, AHIMA). CDI quality chart reviews include:%3C/span%3E%3C/p%3E%3Cul%3E%3Cli%3E%3Cp class=%22MsoHeader%22%3E%3Cspan style=%22font-family:Arial, Helvetica, sans-serif;font-size:12px;%22%3ENew acute inpatient admissions to the facility.%3C/span%3E%3C/p%3E%3C/li%3E%3Cli%3E%3Cp class=%22MsoHeader%22%3E%3Cspan style=%22font-family:Arial, Helvetica, sans-serif;font-size:12px;%22%3EInitial and Concurrent reviews at risk charts with opportunities for improved quality documentation%3C/span%3E%3C/p%3E%3C/li%3E%3Cli%3E%3Cp class=%22MsoHeader%22%3E%3Cspan style=%22font-family:Arial, Helvetica, sans-serif;font-size:12px;%22%3ERetrospective reviews for query identification, documentation clarification, denials, or quality measures.%3C/span%3E%3C/p%3E%3C/li%3E%3Cli%3E%3Cp class=%22MsoHeader%22%3E%3Cspan style=%22font-family:Arial, Helvetica, sans-serif;font-size:12px;%22%3ECompletes quality reviews focused on CDI quality elements, such as Mortality, Hospital Acquired Conditions (HAC), and other publicly reported patient quality or safety metrics (i.e., AHRQ Patient Safety Indicators)%3C/span%3E%3C/p%3E%3C/li%3E%3C/ul%3E%3Cp class=%22MsoHeader%22%3E%3Cspan style=%22font-family:Arial, Helvetica, sans-serif;font-size:12px;%22%3EWhen provider documentation is illegible, incomplete, imprecise, inconsistent, conflicting, or unreliable the CDI Quality Analyst is expected to communicate (i.e., query) with the provider to obtain the necessary information to clarify the medical record (AHIMA, 2014).%26nbsp;%3C/span%3E%3C/p%3E%3Cp class=%22MsoHeader%22%3E%3Cspan style=%22font-family:Arial, Helvetica, sans-serif;font-size:12px;%22%3EThe CDI Quality Analyst must hold a general proficiency within both the clinical and hospital coding skill sets. The CDI Quality Analyst provides the geometric mean length of stay (GMLOS) associated with the working DRG to identify the expected length of stay for acute inpatients.%3C/span%3E%3C/p%3E%3Cp class=%22MsoHeader%22%3E%3Cspan style=%22font-family:Arial, Helvetica, sans-serif;font-size:12px;%22%3E%3Cb style=%22mso-bidi-font-weight:normal;%22%3E%3Cspan style=%22line-height:107%;mso-ansi-language:EN-US;mso-bidi-language:AR-SA;mso-fareast-font-family:Calibri;mso-fareast-language:EN-US;mso-fareast-theme-font:minor-latin;%22%3E%3Cstrong%3E%3Cu%3ECHARACTERISTIC DUTIES AND RESPONSIBILITIES:%3C/u%3E%3C/strong%3E%3C/span%3E%3C/b%3E%3C/span%3E%3C/p%3E%3Cp class=%22MsoHeader%22%3E%3Cspan style=%22font-family:Arial, Helvetica, sans-serif;font-size:12px;%22%3EEstablishes effective and collaborative relationships with members of the hospital community to improve accuracy and completeness of acute inpatient documentation, especially with providers, Health Information Management coding staff, hospital administration, and other patient caregivers.%3C/span%3E%3C/p%3E%3Cp class=%22MsoHeader%22%3E%3Cspan style=%22font-family:Arial, Helvetica, sans-serif;font-size:12px;%22%3EDemonstrate expertise of MS-DRGs, APR-DRGs, documentation opportunities, clinical documentation requirements, and inpatient quality/safety metrics, including but not limited to the elements below:%3C/span%3E%3C/p%3E%3Cp class=%22MsoHeader%22%3E%3Cspan style=%22font-family:Arial, Helvetica, sans-serif;font-size:12px;%22%3E%3Cu%3EClinical Denials:%3C/u%3E%3C/span%3E%3C/p%3E%3Cul%3E%3Cli%3E%3Cp class=%22MsoHeader%22%3E%3Cspan style=%22font-family:Arial, Helvetica, sans-serif;font-size:12px;%22%3EPerforms analysis on clinical documentation, evidenced based criteria application outcome, physician documentation, physician advisor input and complete review of the medical record related to clinical validation, denials, HACs, PSIs and other quality related measures.%3C/span%3E%3C/p%3E%3C/li%3E%3Cli%3E%3Cp class=%22MsoHeader%22%3E%3Cspan style=%22font-family:Arial, Helvetica, sans-serif;font-size:12px;%22%3EAssures appropriate action is taken within appeal time frames to address clinical denial.%3C/span%3E%3C/p%3E%3C/li%3E%3Cli%3E%3Cp class=%22MsoHeader%22%3E%3Cspan style=%22font-family:Arial, Helvetica, sans-serif;font-size:12px;%22%3ECollaborates with Health Information Management for continued appeal processes.%3C/span%3E%3C/p%3E%3C/li%3E%3Cli%3E%3Cp class=%22MsoHeader%22%3E%3Cspan style=%22font-family:Arial, Helvetica, sans-serif;font-size:12px;%22%3ECoordinates Clinical Denial appeal follow up.%3C/span%3E%3C/p%3E%3C/li%3E%3Cli%3E%3Cp class=%22MsoHeader%22%3E%3Cspan style=%22font-family:Arial, Helvetica, sans-serif;font-size:12px;%22%3ECommunicates identified denial trends and patterns to Clinical Documentation Improvement Leadership team.%3C/span%3E%3C/p%3E%3C/li%3E%3Cli%3E%3Cp class=%22MsoHeader%22%3E%3Cspan style=%22font-family:Arial, Helvetica, sans-serif;font-size:12px;%22%3EProvides expert application of evidenced based medical necessity review criteria tool.%3C/span%3E%3C/p%3E%3C/li%3E%3Cli%3E%3Cp class=%22MsoHeader%22%3E%3Cspan style=%22font-family:Arial, Helvetica, sans-serif;font-size:12px;%22%3EUtilizes multiple tools (MS, Tableau, Vizient, etc) to ensure accurate tracking and reporting of clinical denial data.%3C/span%3E%3C/p%3E%3C/li%3E%3Cli%3E%3Cp class=%22MsoHeader%22%3E%3Cspan style=%22font-family:Arial, Helvetica, sans-serif;font-size:12px;%22%3EWorks collaboratively to review, evaluate and improve the denial appeal process and establish a system-wide uniform process.%3C/span%3E%3C/p%3E%3C/li%3E%3Cli%3E%3Cp class=%22MsoHeader%22%3E%3Cspan style=%22font-family:Arial, Helvetica, sans-serif;font-size:12px;%22%3ECollaborates with CDI/HIM Leadership and Physician Advisors in appropriately identified clinical denials requiring escalation.%3C/span%3E%3C/p%3E%3C/li%3E%3Cli%3E%3Cp class=%22MsoHeader%22%3E%3Cspan style=%22font-family:Arial, Helvetica, sans-serif;font-size:12px;%22%3EMaintains clinical expertise and trends in healthcare, reimbursement methodologies and utilization management specialty areas by participating in professional organizations, seminars and educational programs, as requested.%3C/span%3E%3C/p%3E%3C/li%3E%3C/ul%3E%3Cp class=%22MsoListParagraph%22%3E%3Cspan style=%22font-family:Arial, Helvetica, sans-serif;font-size:12px;%22%3E%3Cu%3EQuality Measures%3C/u%3E%3C/span%3E%3C/p%3E%3Cul%3E%3Cli%3E%3Cp class=%22MsoListParagraph%22%3E%3Cspan style=%22font-family:Arial, Helvetica, sans-serif;font-size:12px;%22%3ECollaborates extensively with CDI/HIM partners to ensure all opportunities for quality improvement are identified and addressed on an ongoing basis%3C/span%3E%3C/p%3E%3C/li%3E%3Cli%3E%3Cp class=%22MsoListParagraph%22%3E%3Cspan style=%22font-family:Arial, Helvetica, sans-serif;font-size:12px;%22%3EDemonstrated expertise in use of Vizient risk variable tools and educates others for appropriate use of these tools.%3C/span%3E%3C/p%3E%3C/li%3E%3Cli%3E%3Cp class=%22MsoListParagraph%22%3E%3Cspan style=%22font-family:Arial, Helvetica, sans-serif;font-size:12px;%22%3ELeads/Participates in CDI quality related committees%3C/span%3E%3C/p%3E%3C/li%3E%3Cli%3E%3Cp class=%22MsoListParagraph%22%3E%3Cspan style=%22font-family:Arial, Helvetica, sans-serif;font-size:12px;%22%3EWorks hand in hand with CDI Leadership, Vizient analyst and CDI data analyst to establish a working reporting structure for all areas of specialty, including CDI nurses and members of the coding team.%3C/span%3E%3C/p%3E%3C/li%3E%3Cli%3E%3Cp class=%22MsoListParagraph%22%3E%3Cspan style=%22font-family:Arial, Helvetica, sans-serif;font-size:12px;%22%3EWorks hand in hand with physician advisors to ensure charts identified with patient safety indicators and hospital acquired conditions are reviewed concurrently when possible or retrospectively when necessary.%3C/span%3E%3C/p%3E%3C/li%3E%3Cli%3E%3Cp class=%22MsoListParagraph%22%3E%3Cspan style=%22font-family:Arial, Helvetica, sans-serif;font-size:12px;%22%3EReviews DRG mismatches and reports findings to the DRG variance committee each month.%3C/span%3E%3C/p%3E%3C/li%3E%3C/ul%3E%3Cp class=%22MsoHeader%22%3E%3Cspan style=%22font-family:Arial, Helvetica, sans-serif;font-size:12px;%22%3E%3Cu%3EInternal Education%3C/u%3E%3C/span%3E%3C/p%3E%3Cul%3E%3Cli%3E%3Cp class=%22MsoHeader%22%3E%3Cspan style=%22font-family:Arial, Helvetica, sans-serif;font-size:12px;%22%3EProvides consistent education on clinical documentation opportunities, hospital coding and/or reimbursement issues, as well as performance improvement methodologies to all members of the hospital community.%3C/span%3E%3C/p%3E%3C/li%3E%3Cli%3E%3Cp class=%22MsoHeader%22%3E%3Cspan style=%22font-family:Arial, Helvetica, sans-serif;font-size:12px;%22%3EIdentified opportunities for provider education to improve medical record documentation for severity, morality of other risk adjustment variables. Provides ongoing education as needed for all areas of specialty.%3C/span%3E%3C/p%3E%3C/li%3E%3Cli%3E%3Cp class=%22MsoHeader%22%3E%3Cspan style=%22font-family:Arial, Helvetica, sans-serif;font-size:12px;%22%3EReports finding and trends to hospital committees and initiatives as directed by leadership.%3C/span%3E%3C/p%3E%3C/li%3E%3C/ul%3E%3Cp class=%22MsoHeader%22%3E%3Cspan style=%22font-family:Arial, Helvetica, sans-serif;font-size:12px;%22%3E%3Cu%3EClinical Documentation Improvement:%3C/u%3E%3C/span%3E%3C/p%3E%3Cul%3E%3Cli%3E%3Cp class=%22MsoHeader%22%3E%3Cspan style=%22font-family:Arial, Helvetica, sans-serif;font-size:12px;%22%3EConducts record reconciliation and communicates effectively with hospital coding staff to assign an appropriate working DRG.%3C/span%3E%3C/p%3E%3C/li%3E%3Cli%3E%3Cp class=%22MsoHeader%22%3E%3Cspan style=%22font-family:Arial, Helvetica, sans-serif;font-size:12px;%22%3EReviews all inpatient mortality cases with opportunity and shares findings regularly with leadership and the CDI team.%3C/span%3E%3C/p%3E%3C/li%3E%3Cli%3E%3Cp class=%22MsoHeader%22%3E%3Cspan style=%22font-family:Arial, Helvetica, sans-serif;font-size:12px;%22%3EWorks hand in hand with leadership and educator to ensure all opportunities identified are reported accurately each month.%3C/span%3E%3C/p%3E%3C/li%3E%3Cli%3E%3Cp class=%22MsoHeader%22%3E%3Cspan style=%22font-family:Arial, Helvetica, sans-serif;font-size:12px;%22%3EConsistently attends and participates in meetings related to projects, initiatives, education related to quality driven CDI.%3C/span%3E%3C/p%3E%3C/li%3E%3Cli%3E%3Cp class=%22MsoHeader%22%3E%3Cspan style=%22font-family:Arial, Helvetica, sans-serif;font-size:12px;%22%3EProvides ongoing and regular feedback to CDI team and leads regarding trends for all quality related measures impacted by CDI.%3C/span%3E%3C/p%3E%3C/li%3E%3Cli%3E%3Cp class=%22MsoHeader%22%3E%3Cspan style=%22font-family:Arial, Helvetica, sans-serif;font-size:12px;%22%3EAssists with record review and vacation coverage, as needed%3C/span%3E%3C/p%3E%3C/li%3E%3Cli%3E%3Cp class=%22MsoHeader%22%3E%3Cspan style=%22font-family:Arial, Helvetica, sans-serif;font-size:12px;%22%3EAssists with coding notifications on an as needed basis for additional coverage%3C/span%3E%3C/p%3E%3C/li%3E%3Cli%3E%3Cp class=%22MsoHeader%22%3E%3Cspan style=%22font-family:Arial, Helvetica, sans-serif;font-size:12px;%22%3EDocuments appropriately in the 3M© 360 Clinical Documentation Improvement system.%3C/span%3E%3C/p%3E%3C/li%3E%3Cli%3E%3Cp class=%22MsoHeader%22%3E%3Cspan style=%22font-family:Arial, Helvetica, sans-serif;font-size:12px;%22%3EDemonstrates an understanding of the importance of capturing all potential secondary diagnosis for coding purposes.%3C/span%3E%3C/p%3E%3C/li%3E%3Cli%3E%3Cp class=%22MsoHeader%22%3E%3Cspan style=%22font-family:Arial, Helvetica, sans-serif;font-size:12px;%22%3EMaintains thorough and current knowledge of clinical care and treatment of assigned patient populations to critically assess appropriateness of documentation.%3C/span%3E%3C/p%3E%3C/li%3E%3Cli%3E%3Cp class=%22MsoHeader%22%3E%3Cspan style=%22font-family:Arial, Helvetica, sans-serif;font-size:12px;%22%3EComply with departmental standards regarding attendance, documentation, departmental workflows, continuous quality improvement and statistics, departmental policies and procedures, and the Code of Ethics.%3C/span%3E%3C/p%3E%3C/li%3E%3Cli%3E%3Cp class=%22MsoHeader%22%3E%3Cspan style=%22font-family:Arial, Helvetica, sans-serif;font-size:12px;%22%3EEffectively collaborates and respectfully communicates with fellow CDI team members, the hospital coding team, and quality-driven workgroups to ensure appropriate CDI practices and accurate application of coding/documentation principals.%3C/span%3E%3C/p%3E%3C/li%3E%3Cli%3E%3Cp class=%22MsoHeader%22%3E%3Cspan style=%22font-family:Arial, Helvetica, sans-serif;font-size:12px;%22%3EActively participate in office and/or intradepartmental committees.%3C/span%3E%3C/p%3E%3C/li%3E%3Cli%3E%3Cp class=%22MsoHeader%22%3E%3Cspan style=%22font-family:Arial, Helvetica, sans-serif;font-size:12px;%22%3EPerforms other projects or responsibilities as assigned.%3C/span%3E%3C/p%3E%3C/li%3E%3C/ul%3E%3Cp class=%22MsoNoSpacing%22%3E%3Cspan style=%22font-family:Arial, Helvetica, sans-serif;font-size:12px;%22%3E%3Cb style=%22mso-bidi-font-weight:normal;%22%3E%3Cstrong%3EPercent of Time:%3C/strong%3E%3C/b%3E 100%, Full-time%3Cb style=%22mso-bidi-font-weight:normal;%22%3E%3Cstrong%3E%26nbsp;%3C/strong%3E%3C/b%3E%3C/span%3E%3C/p%3E%3Cp class=%22MsoNoSpacing%22%3E%3Cspan style=%22font-family:Arial, Helvetica, sans-serif;font-size:12px;%22%3E%3Cb style=%22mso-bidi-font-weight:normal;%22%3E%3Cstrong%3ESchedule: %3C/strong%3E%3C/b%3ESome flexibility between the hours of 7:30 AM and 5:00 PM, Monday through Friday.%3Cstrong%3E%26nbsp;%3C/strong%3E%3C/span%3E%3C/p%3E%3Cp class=%22MsoNoSpacing%22%3E%3Cspan style=%22font-family:Arial, Helvetica, sans-serif;font-size:12px;%22%3E%3Cstrong%3ELocation: %3C/strong%3EThis position is primarily remote but may be required to work onsite at times for orientation, education, and other leadership requests. This position is eligible to participate in remote work after the initial training and onboarding has been completed. Initial training and onboarding will take place at the Healthcare Support Services Building (HSSB), 3231 Ridgeway Drive, located in Coralville, IA 52241. Remote work must be performed at a location within the state of Iowa and will require a work arrangement form to be completed upon the start of your employment. Per policy, work arrangements will be reviewed annually, and must comply with the %3C/span%3E%3Ca href=%22https://hr.uiowa.edu/employee-well-being/workplace-flexibility%22%3E%3Cspan style=%22font-family:Arial, Helvetica, sans-serif;font-size:12px;%22%3Eremote work program and related policies%3C/span%3E%3C/a%3E%3Cspan style=%22color:black;font-family:Arial, Helvetica, sans-serif;font-size:12px;%22%3E and the %3C/span%3E%3Ca href=%22https://opsmanual.uiowa.edu/administrative-financial-and-facilities-policies/travel%22%3E%3Cspan style=%22font-family:Arial, Helvetica, sans-serif;font-size:12px;%22%3Eemployee travel policy when working at a remote location%3C/span%3E%3C/a%3E%3Cspan style=%22font-family:Arial, Helvetica, sans-serif;font-size:12px;%22%3E%3Cspan class=%22MsoHyperlink%22%3E.%3C/span%3E%3Cstrong%3E%26nbsp;%3C/strong%3E%3C/span%3E%3C/p%3E%3Cp class=%22MsoNoSpacing%22%3E%3Cspan style=%22font-family:Arial, Helvetica, sans-serif;font-size:12px;%22%3E%3Cstrong%3ESalary level 5A. %3C/strong%3EStarting salary will be based on qualifications and related experience.%3Cstrong%3E %3C/strong%3ETo view the full pay range for salary level 5A:%26nbsp;%3C/span%3E%3Ca href=%22https://hr.uiowa.edu/pay/pay-plans/ps-pay-structures-future#accordion-item-14926-0%22%3E%3Cspan style=%22font-family:Arial, Helvetica, sans-serif;font-size:12px;%22%3EP%26amp;S Pay Structures (Future) | University Human Resources - The University of Iowa%3C/span%3E%3C/a%3E%3C/p%3E%3Cp class=%22MsoNormal%22 style=%22background-color:white;line-height:normal;margin-bottom:9.0pt;vertical-align:middle;%22%3E%3Cspan style=%22background-color:white;color:black;font-family:Arial, Helvetica, sans-serif;font-size:12px;%22%3E%3Cspan style=%22border:1.0pt none windowtext;mso-border-alt:none windowtext 0in;padding:0in;%22%3E%3Cstrong%3EBenefits Highlights:%26nbsp; %3C/strong%3E%3C/span%3EFringe benefit package including paid vacation; sick leave; health, dental, life and disability insurance options; and generous employer contributions into retirement plans. Complete information regarding the full benefits package may be viewed at:%26nbsp;%3C/span%3E%3Ca href=%22https://hr.uiowa.edu/benefits%22%3E%3Cspan style=%22background-color:white;color:#0563C1;font-family:Arial, Helvetica, sans-serif;font-size:12px;%22%3Ehttps://hr.uiowa.edu/benefits%3C/span%3E%3C/a%3E%3C/p%3E
Required Qualifications
A Baccalaureate degree in Nursing or a master's degree in Nursing (MNHP or MSN) is required.
License to practice nursing in Iowa is required.
Two years of inpatient nursing experience in a medical-surgical, and/or ICU setting is required.
Recent work experience as a Clinical Documentation Specialist, CDI nurse, or healthcare quality professional with specific medical record review experience is required.
Must obtain CCDS (Certified Clinical Documentation Specialist) certification within 3 years of hire.
Professional written and verbal communication skills are required
Demonstrates the ability to provide effective education in a variety of styles, including formal presentations.
Proficiency with computer software applications (i.e., Microsoft applications) is required
Demonstrates excellent interpersonal skills with physicians, nursing staff, and interdisciplinary team members as demonstrated through written and verbal communication is required.
Demonstrated organizational, time management and problem-solving skills are required.
Application Process
To be considered for an interview, applicants must upload a current resume and a cover letter that clearly address how they meet the listed required and desired qualifications of this position.
Job openings are posted for a minimum of 7 calendar days. This job may be removed from posting and filled any time after the minimum posting period has ended.
Successful candidates will be required to self-disclose any conviction history and will be subject to a criminal background check.
Professional references will be requested at a later step in the recruitment process.
This position is not eligible for University of Iowa sponsorship for employment authorization.
For questions, contact Heidi Bodensteiner at [email protected].
Requires BSN or MSN, Iowa RN license, 2 years inpatient nursing experience, recent CDI/clinical documentation review experience, proficiency with Microsoft applications and Vizient/Tableau, and CCDS certification within 3 years.
Key Responsibilities
- reviewing records
- analyzing denials
- educating providers
Skills & Tools
Microsoft applications, Tableau, Vizient, 3M 360 Clinical Documentation Improvement system
Job Details
- Category: Healthcare Services - Nursing
- Seniority: Entry Level
- Commitment: Full Time
- Workplace: Remote — Coralville or Iowa City or Iowa
- Languages: English
Benefits
- Retirement plan
About University of Iowa Health Care
An academic health system providing clinical documentation improvement and healthcare services. — Industry: Healthcare