System CDI Quality Reviewer

At Houston Methodist, the System Clinical Documentation Improvement (CDI) Quality Reviewer position is responsible for performing internal quality assurance reviews on Clinical Documentation Specialist (CDS) staff to ensure compliance with national guidelines and policies for complete, accurate and consistent reporting which results in appropriate reimbursement and data integrity. This position reviews outcomes that are communicated to the team to improve the accuracy, integrity and quality of patient data, to ensure minimal variation in practices and to improve the quality of physician documentation within the body of the medical record to support code assignments and communicates outcomes to the CDS team to provide specific education, based on the quality monitoring review findings and trends. This position promotes a partnership between the concurrent clinical reviewers, medical record coders, and physicians to improve documentation and reimbursement.

Requirements:

Qualifications:

LICENSES AND CERTIFICATIONS - REQUIRED

• RN - Registered Nurse - Texas State Licensure and/or Compact State Licensure -- For RN within 60 days OR
• RN-Temp - Registered Nurse - Temporary State Licensure -- For RN within 60 days AND
• For Medical School graduate - Must have one of the following:
• CCDS - Clinical Documentation Specialists (ASDIS) OR
• CDIP - Certified Documentation Integrity Practitioner (AHIMA) OR
• CCS - Certified Coding Specialist (AHIMA)

LICENSES AND CERTIFICATIONS - PREFERRED

• CCS - Certified Coding Specialist (AHIMA)

KNOWLEDGE, SKILLS, AND ABILITIES

• Demonstrates the skills and competencies necessary to safely perform the assigned job, determined through on-going skills, competency assessments, and performance evaluations

• Sufficient proficiency in speaking, reading, and writing the English language necessary to perform the essential functions of this job, especially with regard to activities impacting patient or employee safety or security

• Ability to effectively communicate with patients, physicians, family members and co-workers in a manner consistent with a customer service focus and application of positive language principles

• Demonstrates knowledge of DRG payor issues, appropriate DRG assignment alternatives, clinical documentation requirements, and referral policies and procedures

• Demonstrates accountability and professional development

• Requires excellent observation skills, analytical thinking, problem solving, plus good verbal and written communication

• Ability to interact and maintain regular significant contacts with other personnel throughout the institution (including but not limited to - physicians and their staff, mid-level providers, mid-level staff, coders, Case Managers); contacts methods may be in person, by telephone, or through correspondence

• Ability to display assertiveness while being even tempered, with a pleasing personality and the ability to communicate easily with others

• Working knowledge of Microsoft products including PowerPoint, Word, Excel and Outlook

SUPPLEMENTAL REQUIREMENTS

WORK ATTIRE

• Uniform No
• Scrubs No
• Business professional Yes
• Other (department approved) Yes

ON-CALL*
*Note that employees may be required to be on-call during emergencies (ie. DIsaster, Severe Weather Events, etc) regardless of selection below.

• On Call* No

TRAVEL**
**Travel specifications may vary by department**

• May require travel within the Houston Metropolitan area No
• May require travel outside Houston Metropolitan area No

Company Profile:

Houston Methodist is one of the nation’s leading health systems and academic medical centers. Houston Methodist consists of eight hospitals: Houston Methodist Hospital, its flagship academic hospital in the heart of the Texas Medical Center, and seven community hospitals throughout the greater Houston area. Houston Methodist also includes an academic institute, a comprehensive residency program, a global business division, numerous physician practices and several free-standing emergency rooms and outpatient facilities. Overall, Houston Methodist employs more than 27,000 employees and is supported by a wide variety of business functions that operate at the system level to help enable clinical departments to provide high quality patient care.

Houston Methodist is an Equal Opportunity Employer.

Equal employment opportunity is a sound and just concept to which Houston Methodist is firmly bound. Houston Methodist will not engage in discrimination against or harassment of any person employed or seeking employment with Houston Methodist on the basis of race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, status as a protected veteran or other characteristics protected by law. VEVRAA Federal Contractor – priority referral Protected Veterans requested.