Clinical Document Integrity Specialist 2, Managed Care Network Development Med Mgmt, FT, 8:30A-5P

Overview Baptist Health is the region's largest not-for-profit healthcare organization, with 12 hospitals, over 29,000 employees, 4,500 physicians and 200 outpatient centers across Miami-Dade, Monroe, Broward and Palm Beach counties. The system includes centers of excellence in cancer, cardiovascular care, orthopedics and sports medicine, and neurosciences. Responsibilities Responsible for improving the overall quality and completeness of clinical documentation. Facilitates modifications to clinical documentation through interaction with physicians, nursing staff, other patient caregivers, and medical records coding staff to ensure appropriate reimbursement for DRG-based payors. Ensures accuracy and completeness of clinical information used for measuring and reporting physician and medical center outcomes. Educates all members of the patient care team on an ongoing basis. Actively participates in team meetings and educates staff in the CDMP process. Qualifications Doctor of Medicine / DO. International graduates of medical school, or RN with MBA preferred. Four years of recent clinical experience adult, pediatrics, obstetrics hospital inpatient medical, surgical and critical care setting. Four years of recent clinical documentation improvement experience in adult/pediatric hospital inpatient medical/surgical and critical care setting. CDIS certification preferred. Experience in Milliman and Interqual preferred. Leadership experience, knowledge of legal aspects of coding, Medicare MS-DRG, Medicaid APR-DRG assignments, utilization management, case management, discharge planning, and/or managed care experience preferred. Experience using healthcare web-based applications, Milliman, InterQual, etc. Basic computer skills (Windows-based software). Incumbents hired prior to 6/4/2023 may be a Certified Coding Specialist or a Registered Nurse to continue in a Clinical Document Specialist role. Anyone hired after 06/4/2023 must be a Foreign Medical Graduate. Minimum Experience Minimum Required Experience: 4 Years Equal Employment Opportunity EOE, including disability/vets #J-18808-Ljbffr Baptist Health