HCC Clinical Documentation Lead (RN)

Overview:

To be part of our organization, every employee should understand and share in the YNHHS Vision, support our Mission, and live our Values. These values - integrity, patient-centered, respect, accountability, and compassion - must guide what we do, as individuals and professionals, every day.

As a member of the Center for Population Health, the HCC Documentation Lead (RN), while incorporating the role of the HCC Documentation Specialist, is expected to demonstrate a higher level of comprehension and expertise in HCC Documentation integrity and is responsible for overall coordination of HCC Documentation specialists, provide procedural guidance, and assumes responsibility for achieving desired results in conjunction with leadership and program manager support. The HCC Documentation Lead will serve as a partner and subject matter expert on HCC coding and documentation for clinicians who are a part of our Clinically Integrated Network (CIN), Yale New Haven Health Clinical Affiliates. The position is responsible for leading the efforts related to clinician education regarding documentation opportunities through appropriate channels on an ongoing basis. Working with leadership and staff, the HCC Documentation Lead will contribute to content development and ongoing documentation; participates and organizes projects related to performance improvement.

EEO/AA/Disability/Veteran

Responsibilities:

• 1. Pre Visit Support

• • 1.1   Provide support to clinicians through patient record reviews in advance of patient visits, focused on
    recapture of HCCs and other potential chronic diagnoses, evaluating new HCC diagnosis capture
    opportunities based on appropriate clinical indicators and validation of data-driven suspect diagnoses.
  • 1.2 Provides second-level reviews and assists with audits of documentation for quality and accuracy
    assurance, as needed. Serves as a resource for team to ensure efficient query response .
  • 1.3  Organizes special projects. Acts as a resource to direct the project team. Involved in initiatives such
    as clinician engagement (i.e. response rate) and administration engagement (i.e. KPI and metric
    development)
  • 1.4 Functions as a subject matter expert and actively participates in department meetings as a problem
    solver. Expert in workqueue and workflow management.
  • 1.5 Ensures efficiency and productivity of the processes and workflows of team , participating in orientation
    of new hires, reporting issues to leadership, and getting involved in committees / projects.
  • 1.6 Identifies opportunities for performance improvement through evaluation of trends and proposes potential
    solutions.
  • 1.7 Partners with coding and billing teams to ensure completeness of supporting documentation, as
    appropriate.

• 2. Clinician Education

• • 2.1 Interact with clinicians regarding questions about pre-visit documentation needs or suspect diagnoses
  • 2.2 Educate clinicians and internal staff on HCC documentation and guidelines using a multi -model
    approach, including 1:1, group and pre-recorded sessions in coordination with other members of the
    Center for Population Health
  • 2.3 Works with other members of the Center for Population Health to develop educational content.
  • 2.4 Provide ongoing team learning opportunities through sharing of professional knowledge.

• 3. Staff oversight

• • 3.1 Provide day to day guidance and support to HCC Documentation Specialists, clarifying priorities and role expectations.
  • 3.2 Identify and assist in the development of skill sets through regular feedback channels for individual team
    members.
  • 3.3 Participate in annual performance reviews

• 4. Performs other duties as assigned or directed.

• • 4.1 Performs other duties as assigned that support the program to meet program and organizational goals.

Qualifications:

EDUCATION

 

Registered Nurse with active RN required, BSN preferred. CCS-P, CPC, CRC, or other coding credential required.

 

EXPERIENCE

 

Experienced HCC Documentation Specialist with minimum of three (3) years experience in role. At least three (3) years of recent acute care nursing experience required; ICU experience preferred. Previous clinical leadership experience preferred.

 

LICENSURE

 

RN license required. CCS-P, CPC, CRC, or other coding credential required.

 

SPECIAL SKILLS

 

Excellent communication and organizational skills. Adaptability to a wide variety of interpersonal encounters with the care team. Comprehensive understanding in use of medical record to extract data. Computer PC literacy required. Must be able to work collaboratively and independently. Must be flexible with responsibilities in order to meet departmental needs. Must have keen eye to detail. Ability to develop and maintain supportive, collaborative relationships with physicians and other clinical professionals. Ability to track activities and communications across multiple physician services and forums.

 

PHYSICAL DEMAND

 

Ability to communicate clearly and confidently to clinicians the program goals and documentation opportunities using email, in personal communication, telephone or other written and electronic forms of communication. Primarily remote position, however occasional on site participation in meetings, trainings and conducting education sessions may be required on ad hoc basis.