Position Summary: We have an exciting opportunity to join our team as a Clin Doc Improvement Qual Analy.
This position will identify areas for process improvement. Based on metric analysis findings, action plans will be developed and disseminated to Clinical Documentation Improvement program (CDI) Director and HIM Directors who will correct knowledge gaps though on-site education and training for CDI and Coding. This position will collaborate data reports for the Coding and CDI departments. This position will develop and maintain a relationship with the Hospital Performance & Analytics Department and Epic Clin Doc team analyst to optimize use of Epic, identifying gaps and areas for ideal performance.
The CDI analyst will be a content expert in Vizient and Tableau databases.
Additionally, this position will be current on CDI best practice standards and support the mission, vision and values of CDI program. In addition to the responsibilities described above, the role may include other responsibilities and duties assigned based upon NYU Langone Health System needs or requirements.
Content expert for Vizient and Tableau and other software as deemed necessary
Identifies educational opportunities by individual site and individual Clinical Documentation Specialist (CDS) to improve comorbidity documentation related to financial reimbursement and data metrics
Makes site visits and instructs individual coder or CDS as needed to close knowledge gap as needed
Develops CDI program outcomes tracking tools and dashboards to capture financial and data trends
Trains new staff upon hiring on Epic and DRG strategies, and other sources of data for CDI use to ensure CDI team understand finical impact related to DRGs and increased reimbursement opportunities
Supports Director to track metrics, assess ICD-10 capture quality, and 3M profile reports to create charts/graphs for presentations to Executive staff and physician leadership
Supports Director and Strategies Analyst to ensure optimization of Epic, VBM initiative and financial savings , and other initiatives/directives
Analyze CDI program metrics for operation improvement based on review of key performance indicators, and provides data to justify operational changes and priorities
Analyzes data to determine revenue impact related to CDI projects to determine priority and value for optimal financial impact
Analyzes data to quantify revenue protection based on averting risk though CDI projects to minimize denials and financial loss
Communicates orally and in writing in concise understandable terms with all people involved in the development and implementation of applications
Remains current on upgrades, new products and emerging technologies with 3M and Epic
Maintain databases, spreadsheets, files, memos and graphic applications utilizing various software programs
Monitor trends in CC/MCC capture rates, communicate both positive (increased financial impact) and negative trends (decreased financial impact)
Supports the program/project manager with the maintenance of project plans and schedules
Prepare data analysis for CDSs to use in presentations for providers to demonstrate how documentation influences financial reimbursement and quality scores
Demonstrate an understanding of complications, co-morbidities, severity of illness, risk of mortality, case mix, secondary diagnosis, impact of procedures on the final DRG, other related metrics, and an ability to impart this knowledge to physicians and other members of the healthcare team
Utilizes the health system’s designated clinical documentation system(s) to identify opportunities for physician to improve documentation related to financial and data outcomes
Provides or coordinates education to all internal customers related to compliance, coding, and clinical documentation issues
Participates in development of educational materials for shared use by CDI teams across the Health systems to maintain consistent content delivery
Assist with developing CDI clinical criteria policies for consistency in CDI query and coding practices across the Health System and to use in appeals and denials for financial recovery
Gather and analyze information pertinent to documentation findings and outcomes
Research literature to identify new methods for development and overall documentation enhancement
Stays current on all CDI-related literature and current pathophysiology
Assists CDI teams to accommodate census fluctuation across sites to ensure ability for CDI to maintain review expectations
Assist in the development and reporting of performance measures to the medical staff and other departments and prepare physician specific data information
Monitor transfer cases that move between sites and maintain process knowledge for smooth transition among CDI team and use of the different software systems used by CDI
Active participation on departmental and hospital committees and assigned Task Force groups
Coordinate and work effectively with Clinical Documentation Specialists
Contribute to a positive working environment and performs other duties as assigned or directed to enhance the overall efforts of the organization
Maintain credentials/licensure/certification Demonstrates knowledge of NYULMC service standards, New York State Hospital regulations and Federal HIPAA guidelines and is compliant throughout the performance of duties.
Other duties as assigned
Experience & skills
A minimum of 3 years data analytics and/or acute care experience
Experience training staff with Epic, 3M, Microsoft Office, and Kronos applications preferred
Proficiency in organization and planning
Experience working with teams and on projects
Working knowledge of quality improvement theory and practice
Demonstrates adaptability and self-motivation by staying abreast of CMS rules and regulations and incorporating those changes into daily practic
Experience with utilization management, coding, billing, auditing and various healthcare payers is preferred
Knowledge of federal, state and private payer regulations
Excellent interpersonal, organizational, presentation, verbal and written communication abilities
Ability to effectively communicate, both orally and in written form, with people at all levels of the organization
Proficient computer and technical skills necessary in order to perform the tasks required, including advanced knowledge of information systems, databases, payroll, and spreadsheet applications
Ability to work collaboratively with diverse groups
Ability to deal with conflicting interests and to resolve situations effectively with prioritization
Work to leverage performance, providing feedback and influence to assist in driving continuous improvement in the development and deployment of standard policies and procedures, technology tools, and strategies targeted to improve the quality of documentation and overall facility financial performance
Knowledge of hospital reimbursement models and trends (ACOs, Medicare Advantage, bundled payment, etc.) and their impact to the health systems and physician providers
Bachelor's degree in nursing, health information management or equivalent; Master’s degree preferred
Current nursing (RN) or HIM certification (RHIA, RHIT, CCS).
Graduate education leading to MD, DO, or equivalent degree
3+ years’ experience in acute care, health care administration or commensurate experience
Demonstrated knowledge relevant to clinical and regulatory aspects of care and reimbursement
Experience with ICD-10 coding and DRG assignment. Good oral and written communication skills. Excellent interpersonal skills.
Master's degree in nursing, HIM or related field.
Experience training staff with Epic applications preferred
Working Conditions/Physical Demands:
Health Information Management office and hospital units; contact with clinical staff
Qualified candidates must be able to effectively communicate with all levels of the organization.
NYU Langone Health provides its staff with far more than just a place to work. Rather, we are an institution you can be proud of, an institution where you'll feel good about devoting your time and your talents.
NYU Langone Health is an equal opportunity and affirmative action employer committed to diversity and inclusion in all aspects of recruiting and employment. All qualified individuals are encouraged to apply and will receive consideration without regard to race, color, gender, gender identity or expression, sex, sexual orientation, transgender status, gender dysphoria, national origin, age, religion, disability, military and veteran status, marital or parental status, citizenship status, genetic information or any other factor which cannot lawfully be used as a basis for an employment decision. We require applications to be completed online. If you wish to view NYU Langone Health's EEO policies, please click here. Please click here to view the Federal 'EEO is the law' poster or visit https://www.dol.gov/ofccp/regs/compliance/posters/ofccpost.htm for more information. To view the Pay Transparency Notice, please click here.
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Internal Number: 63757035
About NYU Langone Health
NYU Langone Health is a world-class, patient-centered, integrated academic medical center, known for its excellence in clinical care, research, and education. Included in the 200+ locations throughout the New York area are five inpatient locations: Tisch Hospital, its flagship acute-care facility; Rusk Rehabilitation, ranked as one of the top 10 rehabilitation programs in the country; NYU Langone Orthopedic Hospital, a dedicated inpatient orthopedic hospital with all musculoskeletal specialties ranked top 10 in the country; Hassenfeld Children's Hospital at NYU Langone, a comprehensive pediatric hospital supporting a full array of children's health services; and NYU Langone Hospital—Brooklyn, a full-service teaching hospital and level 1 trauma center located in Sunset Park, Brooklyn. Also part of NYU Langone Health is the Laura and Isaac Perlmutter Cancer Center, a National Cancer Institute–designated cancer center, and NYU School of Medicine, which since 1841 has trained thousands of physicians and scientists who have helped to shape the course of medical history.