Nurse – Clinical Documentation Integrity, PACE

🕒 vor 28 Tagen

🔔 Pennsylvania – Remote

🔔 Pennsylvania – Remote

⏰ Vollzeit

🟡 Mittelstufe

🟠 Senior

🏥📝 Medizinischer Autor

👻 Geisterscore 13%

Was es bedeutet: wie wahrscheinlich diese Stelle offen bleibt, ohne dass aktiv eingestellt wird.So liest du es: 60 % oder höher heißt, wir halten das für einen Geisterjob. Niedrigere Werte sind weniger bedenklich.Wie wir werten: Dauer offen, Neuveröffentlichungen, offene Stellen vs Teamgröße, wie schnell Stellen geschlossen werden, und ob ein Gehalt angegeben ist.Hinweis: eine Schätzung aus öffentlichen Daten, kein Urteil über das Unternehmen. Echte Stellen können hoch punkten, nutze es also als Hinweis, nicht als Fakt.

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One Senior Care

WebsiteLinkedInAlle Stellen

201 - 500 Mitarbeiter

🏥 Gesundheitswesen

📦 Logistik

💼 Beratung

Healthcare • Logistics • Consulting

One Senior Care setzt sich dafür ein, die Lebensqualität älterer Menschen zu verbessern – insbesondere in ländlichen und unterversorgten Regionen. Dafür bietet das Unternehmen umfassende, personenzentrierte Gesundheits- und Sozialdienstleistungen an. Im Mittelpunkt steht die Unterstützung von PACE-Programmen durch innovative Lösungen und herausragenden Service. So können sich Pflege- und Betreuungskräfte auf eine hochwertige Versorgung konzentrieren und gleichzeitig administrative Belastungen reduzieren. One Senior Care fördert Partnerschaften zwischen Verantwortlichen von PACE-Organisationen, um Best Practices gemeinsam weiterzuentwickeln, Ressourcen zu teilen und die Versorgungsergebnisse für ältere Menschen zu verbessern. Dadurch sollen sie möglichst lange selbstständig in ihrem Zuhause leben können.

Beschreibung

• Review existing medical records and approved clinical intelligence reports to identify documentation opportunities for provider review • Review provider notes, hospital, emergency department, and skilled nursing records, specialist documentation, medication profiles, labs, imaging, assessments, care plans, and prior documentation • Apply clinical documentation and coding knowledge, including CC-focused coding experience, when reviewing documentation opportunities • Identify documentation gaps related to condition status, specificity, acuity, chronicity, complications, treatment, monitoring, and assessment or plan clarity • Prepare concise, neutral clinical summaries for provider review • Present supporting evidence by date, location, and document type without directing the provider to a specific diagnosis or code • Support provider workflow during annual, semiannual, high-risk, complex care, and post-discharge visits • Facilitate appropriate non-leading clarification when documentation is incomplete, inconsistent, or unclear • Provide education to providers and clinical teams regarding documentation completeness, specificity, provider charting, and audit readiness • Monitor documentation trends, recurring gaps, and opportunities for improvement • Participate in quality reviews, compliance reviews, and audit-readiness activities • Collaborate with coding, risk adjustment, compliance, clinical leadership, and provider teams to improve documentation workflows • Provide functional oversight and guidance to Medical Assistants supporting documentation preparation • Help build and refine standardized workflows, work queues, templates, prioritization criteria, and turnaround expectations • Provide onboarding, training, competency validation, coaching, and feedback to Medical Assistants • Review samples of MA-prepared documentation for accuracy, completeness, neutrality, organization, and timeliness • Monitor documentation preparation workload, completion rates, rework, quality findings, and barriers • Help identify opportunities to improve and expand the CDI program • Work collaboratively with leadership to establish best practices, processes, and standards • Escalate privacy concerns, unsupported documentation, non-neutral language, or compliance concerns through established channels • Participate in quality improvement initiatives and ongoing training • Maintain confidentiality and a private, secure remote workspace • Participate in virtual meetings and maintain consistent communication with providers, leadership, and clinical teams • Travel between centers or other locations as needed • Do not independently diagnose Participants or select, assign, sequence, recommend, or submit diagnosis data • Help build structure, develop workflows, identify opportunities, and establish best practices as the CDI program grows

🎯 Anforderungen

• Active, unrestricted Registered Nurse license in the applicable state • Minimum of 3 to 5 years of clinical nursing experience • Previous experience in Clinical Documentation Integrity, provider documentation, coding, risk adjustment, or a similar role required • Previous experience reviewing provider charts and clinical documentation required • Demonstrated coding experience with a CC focus required • Strong understanding of provider documentation and charting practices required • Experience reviewing electronic medical records and clinical documentation required • Strong clinical judgment and understanding of clinical documentation standards • Strong understanding of provider charting and clinical documentation practices • Strong computer and electronic medical record skills • CPR and First Aid Certification (or willingness to obtain after hire — training provided) • Experience working with older adults, medically complex Participants, chronic disease management, PACE, home-based care, or community-based care preferred • Experience providing training, coaching, quality review, or workflow oversight to Medical Assistants or other clinical support staff preferred • Experience with PACE, Medicare Advantage, value-based care, clinical documentation integrity, quality, audit, or risk adjustment is a plus • Ability to maintain confidentiality and protect sensitive Participant information • Ability to maintain a private and secure workspace when working remotely • Ability to work independently and manage priorities in a remote environment • Must be able to participate in virtual meetings and maintain consistent communication with providers, leadership, and clinical teams • Must be able to travel between centers or other locations as needed • Successful completion of required background checks, health and safety screenings, and any clearances required for healthcare programs • Must be able to sit and work at a computer for extended periods • Must be able to move intermittently throughout the workday • Must be able to remain focused and attentive while reviewing detailed clinical information • Must be able to use standard office and computer equipment

🏖️ Vorteile

• 9 Paid Holidays • PTO starting at 3 weeks + 1 day per year (accrued from date of hire for full-time employees) • Medical, Dental, & Vision • Free Life and AD&D Insurance Plan • Health Savings and Flexible Spending Accounts • Short Term Disability Insurance • Group Voluntary Term Life Insurance for Employee, Spouses, and Dependents • Paid Parental Leave • Tuition Reimbursement and Paid Training Opportunities • Retirement Plan with company annual match • Mileage Reimbursement at annual IRS rate as applicable • Training, mentorship, and career development programs