Responsible to develop and update department clinical guidelines and develop new queries and update current queries as needed Develops policies/guidelines to assure a smooth and compliant CDI program that supports the education and development of the department. Identifies areas where clinical documentation and coding can improve workflow.Monitors CDS audit trends and ensures compliant and effective queries Reviews query type trends and report out on physician query response times.Creates joint standards for chart review and querying by diagnosis Assist with IT strategy and implementation with Epic team and external software vendors.Develops and implements educational programs that can improve the documentation and coding of specific metric driven data Collaborates with the Quality department to identify specialty specific documentation needs to improve reported metrics.Acts as a preceptor and ensures follow up as needed Participates in the interviewing and hiring of new staff and execute new hire orientation.Develops and executes clinical education to the CDS and coding staff and provides continuous feedback on directed education and specific needs Provides education plans for all levels of CDS at both a group and individual level.Collaborates with physicians, leaders and the CDS staff to address specialty specific documentation needs and provides clinical documentation education.Coordinates ongoing clinical documentation provider education across the JPS Health Network and community.Designs, delivers and assesses learning activities and curriculums related to competencies, departmental policies, regulatory requirements, and the use of information technologies.Collaborates with leadership to assess the learning needs and competencies of the department and identify issues for education and training to address specialty specific documentation needs.Educates physicians, case management, charge nurse and other departments as needed.Maintains appropriate non-leading queries concurrently to physicians.Assists in screen processes, making referrals, interacting with case managers and clinical nurse specialists to ensure continuity of patient care.Tracks response to CDS and trends completion of Navigant CDI monitor Ensures the accuracy and completeness of clinical information used for measuring and reporting physician and medical center outcomes.Facilitates modifications to clinical documentation through concurrent interactions with physicians and.Performs clinical evaluation of the medical record including physician documentation and clinical results.O Obtains and promotes appropriate clinical documentation through extensive interaction with physicians, nursing staff, and other patient caregivers to ensure that the documentation of the level of service rendered to the patient and the patient’s clinical complexity is complete and accurate.
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