Sep 26, 2022

Utilization Review/Clinical Documentation Improvement Specialist

  • Upstate Nursing
  • Syracuse, NY, USA

Job Description

Utilization Review/Clinical Documentation Improvement Specialist

Job no: 73827
Department: Utilization Management
Employer: State of New York
Payroll Title: T H Util. Review/Quality Assur. Sr Coord., NSSL4
Bargaining Unit: UUP (State University Professional Services Unit)
Salary: Commensurate with Qualifications
Work type: Full-time
Location: Syracuse
Categories: Registered Nurses

Job Summary: The Clinical Documentation Improvement Specialist will conduct a comprehensive review of the patient's medical record to identify and assess that the record reflects accurate information related to the admission, diagnosis and specificity of the clinical terminology. The candidate will facilitate communication and collaboration among the physicians, coders, nurses and other interdisciplinary team members to identify documentation opportunities and then acquire complete clinical information in the record. Will attend meetings with Clinical Data staff, the Medical Director and various other committees. Responsible for attending rounds, providing education to staff as requested to enhance compliance, performing robust review of reports and data. The Clinical Documentation Improvement Specialist generates both written and verbal physician queries, as a means of communication, in cases where additional documentation is needed to support the severity of the patient's condition. Reports to the Utilization Management department and works collaboratively with the UM staff for overall identification of patient safety and quality initiatives.
Minimum Qualifications:

NYS Licensed/Registered (or eligible) RN, Bachelors Degree in Nursing (or healthcare related field) and a minimum of three years RN nursing experience, or Associates Degree in Nursing and five years nursing experience required. Excellent communication and customer service skills required for interface with health care payers, regulatory agencies and other health care related entities.

Preferred Qualifications:

Candidates with a minimum of 3 years of acute care experience, strong computer skills and knowledge of Community, State & Federal laws, regulations and resources preferred. Current knowledge of CMS regulations and guidelines for patient safety and quality initiatives preferred. Coding or CDI experience highly desirable.

Work Days:

Monday - Friday, 8:00 am - 4:30 pm

Message to Applicants: This position is primarily remote with some onsite duties.
Recruitment Office: Human Resources
Executive Order: Pursuant to Executive Order 161, no State entity, as defined by the Executive Order, is permitted to ask, or mandate, in any form, that an applicant for employment provide his or her current compensation, or any prior compensation history, until such time as the applicant is extended a conditional offer of employment with compensation. If such information has been requested from you before such time, please contact the Governor's Office of Employee Relations at (518) 474-6988 or via email at