Nurse Practitioner - CDI Advisor - Casual

Fairview Health Services • St. Paul, MN

6h

About The Position

Fairview is seeking a Clinical Documentation Integrity (CDI) Nurse Practitioner Advisor to act as a key stakeholder in the CDI program to help set and implement strategy and partner with the team to support the program to improve documentation capture. The role will liaison between the CDI team and the medical staff to facilitate accurate and complete documentation, education, and support in resolution of queries and problem accounts. This includes documentation for coding and abstracting of clinical data, capture of severity, acuity, and risk of mortality, in addition to diagnosis coding and DRG assignment (as appropriate) with emphasis on inpatient or outpatient status cases. The CDI Nurse Practitioner Advisor will help develop, maintain, and facilitate documentation and coding training for APRN/PA's (including residents involved in patient care and documentation). The role will work closely with Revenue Cycle and other corporate departments, providers, and payers to remain current with documentation requirements, reporting and trends to optimize expertise and outcomes associated with this role. Will leverage reporting, claims data, appeals and audit requests related to clinical determination and DRG downgrades (as appropriate) to improve documentation and education strategy.

Requirements

• Nurse Practitioner with relevant clinical experience
• 5 years experience in hospital medicine or outpatient medicine
• Hold and maintain an unrestricted Nurse Practitioner license in Minnesota

Nice To Haves

• 10 years experience in hospital medicine
• 10 years experience in medical informatics, health IT, or Epic
• Leadership experience

Responsibilities

• Works in partnership with coding (inpatient, outpatient, and/or professional), clinical documentation integrity (CDI, coding quality and provider support) teams to develop and implement programs and optimize people, process, training and technology related to clinical documentation capture.
• Works with CDI and revenue cycle teams to understands healthcare reimbursement systems: Centers for Medicare and Medicaid Services (GR) Grouper (CMS), to leverage knowledge in program outreach and impact as appropriate.
• Works with CDI and revenue cycle teams to understand the intricacies of ICD-10-CM/PCS, CPT, HCPCS Codes, MS- DRG, APR-DRG, and the Medicare Inpatient Prospective Payment System (IPPS), aligned with the patient classification, to make medical determinations based on severity of illness, acuity, and risk of morbidity/mortality. Also, considering chronic conditions, outpatient managed care, social determinates of health (SDOH) and medical decision making.
• Educates advanced practicing registered nurses and physician assistants on the importance of appropriate documentation, impacts of coding, and clinical terminology to improve their understanding and administration of diagnosis coding specificity, severity, acuity, risk of mortality, and DRG (MS and APR) assignments on patient records.
• Helps to identify, onboard, and engage providers in CDI content and improvement to maximize outreach and program impact.
• Supports departmental strategies related to provider onboarding education, workflow, system enhancements and other tactics to optimize access, communication, adoption, and outcomes for the health system.
• Works in partnership with reporting and analytics. Use data for predictive analysis to help guide business decisions and drive priorities/performance improvement.
• Understand key performance indicators and utilize CDI metrics including benchmark data regarding documentation performance in order to create and implement documentation improvement plan(s) and prioritization for facilities.
• Develops tactics and opportunities based on industry best practice and benchmarks leveraging Vizient, MHA, MedPar data, US News World Reports, or other local and national reports.
• Partners with the CDI teams, service line champions, and other internal and external stakeholders to develop and maintain a robust provider support program across the system.
• Reviews and provide feedback on documentation policy changes for medical staff.
• Assists CDI team with navigating the complexity of the medical staff structure. Helping to engage the correct medical staff and stakeholder groups for collaboration.
• Support and assist with Denials Prevention, encounters open greater than 3 days, Population Health, preventable visit rates, readmission rates and DRG Downgrades (e.g. Peer to Peer Review with payors when appropriate.)

Benefits

• Fairview offers a generous benefit package including but not limited to medical, dental, vision plans, life insurance, short-term and long-term disability insurance, PTO and Sick and Safe Time, tuition reimbursement, retirement, early access to earned wages, and more!
• Please follow this link for additional information: https://www.fairview.org/careers/benefits/noncontract

What This Job Offers

• Job Type: Part-time
• Education Level: No Education Listed