CDQI Nurse Specialist

About Datavant

Datavant is the trusted data collaboration platform in healthcare, dedicated to making health data secure, accessible, and actionable. We empower organizations across the healthcare ecosystem, from providers and health plans to researchers and life sciences companies, to connect and utilize data to improve health outcomes. Joining Datavant means becoming part of a driven and highly collaborative team committed to transformative change in healthcare.

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About the CDQI Nurse Specialist Role

As a CDQI Nurse Specialist, you will play a pivotal role in elevating the impact of medical record documentation. Your daily responsibilities will include evaluating documentation and engaging directly with providers to enhance clarity, completeness, and overall medical record quality. By ensuring accurate and comprehensive physician documentation, you will directly influence the precision of code assignment, significantly impacting the accuracy of healthcare data and patient care effectiveness.

What You Will Do

• Conduct timely, accurate, and complete documentation reviews for selected inpatient records, addressing inadequate or conflicting documentation.
• Collaborate with physicians and caregivers to ensure appropriate reimbursement and clinical severity for DRG-based payer patients.
• Demonstrate understanding of complications, co-morbidities, severity of illness, risk of mortality, case mix index, secondary diagnoses, and procedure impact on DRG.
• Improve coding specificity by educating physicians and caregivers on the importance of clear documentation throughout a patient's stay.
• Follow AHA guidelines and coding clinics for accurate coding and required documentation to ensure compliance.
• Query physicians regarding missing, unclear, or conflicting health record documentation to obtain necessary details.
• Maintain daily production logs for evaluation, tracking cases reviewed, queries placed/responded, etc.
• Perform follow-up reviews to confirm recorded points of clarification in the patient's medical record.
• Ensure confidentiality of all files, documents, and records.
• Meet or exceed production and quality metrics.

What You Need To Succeed

• 3+ years of CDI experience.
• 3+ years of clinical experience in an academic medical center.
• Registered Nurse license.
• Bachelor's degree in Nursing.
• CCDS or CDIP certification required.
• Must pass a CDI skills competency assessment.
• Ability to accommodate a minimum of 15 hours per week.

Key Skills/Competency

• Clinical Documentation Improvement (CDI)
• Medical Record Review
• Physician Education
• DRG Reimbursement
• Coding Compliance (AHA Guidelines)
• Healthcare Data Accuracy
• Registered Nurse (RN)
• CCDS/CDIP Certification
• HIPAA Compliance
• Communication Skills