Second Level Reviewer, (Registered Nurse or Medical Doctor) in El Paso, Texas at University Medical Center of El Paso

Job Summary:

The Clinical Documentation Second Level Reviewer performs high risk, high-level, complex, secondary case reviews to facilitate and obtain appropriate provider documentation for clinical conditions or procedures to reflect severity of illness, expected risk of mortality, accuracy of patient outcomes, and complexity of patient care. Serves as key resource for CDI, coding and quality. Works in collaboration with CDI & quality leadership, CDI specialists, coders, quality analysts, providers, and other members of the healthcare team to ensure accurate, high-quality clinical documentation to support hospital initiatives. Adheres to departmental and organizational goals, objectives, standards of performance, policies and procedures, continually ensuring quality documentation and regulatory compliance.

1. Minimum Job Requirements:

Work Experience:

Three years of direct patient care in hospital setting required. Three years of experience working with inpatient clinical documentation, mortality, PSI, HAC, or other quality-focused reviews required.

License/Registration/Certification:

Certified Clinical Documentation Specialist (CCDS) or Certified Documentation Integrity Practitioner (CDIP) certification required.

The candidate must obtain the certification within two years of starting the role.

Education and Training:

Bachelor's Degree in Nursing, Master’s degree in Nursing preferred, OR

Master’s degree in a health related field. OR

Graduate from a medical school with MD or equivalent required.

Skills:

1. 1. Extensive clinical knowledge, critical-thinking skills, and understanding of disease processes, pathophysiology, and disease management/treatment.
   2. Knowledge of Vizient, Premier, US News and World Report, CMS star rating or similar risk-adjustment methodologies highly preferred.
   3. Proficiency with CDI software (EZDI), CERNER and encoder. Experience with 3M 360 Encompass preferred.
   4. General knowledge of office procedures and operations.
   5. Knowledge of US News and World Report risk-adjustment systems to identify clinical documentation improvement opportunities preferred.
   6. Skill in data entry with minimal errors.
   7. Ability to accurately prepare and maintain records, files, reports and correspondence.
   8. Ability to communicate effectively in both oral and written form.
   9. Ability to handle difficult and stressful situations with professional composure.
   10. Ability to maintain effective interpersonal relationships.
   11. Ability to understand and follow instructions.
   12. Proficiency with ICD-10-CM/PCS, APR DRG, and MS DRG required.