Yale New Haven Health System

  • HIM CLIN QUALITY SPECIALIST-PD

    Job Locations US-CT-New Haven
    Job ID
    69333
    Department
    Payer Audit
    Category
    RN/NURSING - ALL OTHER
    Position Type
    Casual/Per Diem Non-Benefits Eligible
    Work Schedule
    DAYS
    Work Days
    MONDAY - FRIDAY
    Work Hours
    7:30A - 4PM (NEGOTIABLE)
    Work Shift
    NONE
    Requisition ID
    2018-22198
  • 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.

    This position performs specific duties to support accurate and complete documentation of patient acute and chronic conditions in collaboration with the North East Medical Group Value Based department. These duties include abstracting clinical data from the Epic EMR that supports coding and closes gaps in patient care. Tasks include transcribing the correct level of complications secondary to disease state, preparing supporting documents, and submitting a comprehensive document to payers. Works to identify and address reported gaps in care in our patient population, and works with providers and staff to improve HEDIS quality scores across our physician network.
    The position adheres to all five "Standards of Professional Behavior" and promotes a positive work environment.

    EEO/AA/Disability/Veteran

    Responsibilities

    • 1. Under the supervision of the Clinical Education Administrator, obtains records from Epic, collates documents, and completes accurate clinical documentation to support diagnosis in accordance with regulations and guidelines.
    • 2. Reviews charts for clinical documentation and abstracts patient data to support closing gaps in care according to HEDIS guidelines.
    • 3. Submits forms and collated documents to payers and follows process for submitting all documentation in accordance with YNHHS policy and HIPPA standards.
    • 4. Effectively and professionally communicates and interacts with NEMG clinician and administrative staff.
    • 5. Maintains spreadsheets with up to date data for program submissions
    • 6. Utilizes spreadsheets to follow up on patients who require a form to be completed/submitted.

    Qualifications

    EDUCATION


    Graduation from an accredited School of Nursing, Licensed and a currently registered nurse (R.N.) in the State of Connecticut. BSN preferred.


    EXPERIENCE


    Minimum one year of ambulatory or inpatient patient care including clinical nursing and documentation in the Epic EMR.


    LICENSURE


    Active CT RN License


    SPECIAL SKILLS


    Excellent interpersonal, coordinative, customer service, teamwork, and organizational skills.
    Demonstrated ability to communicate effectively with interdisciplinary team and administration.
    Ability to multitask is essential.
    Able to function well in a matrixed environment.
    Epic EMR experience is required
    Demonstrated competencies in Epic Release of Information functionality (training will be provided).
    Working knowledge of Microsoft office applications is preferred (includes proficiency with Excel).


    PHYSICAL DEMAND


    Sitting long periods of time, Data entry and use of computer system.


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