CDI Quality Liaison

Site: Mass General Brigham Incorporated

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Job Summary

The Clinical Documentation Integrity (CDI) Quality Liaison is responsible for oversight and development of CDI processes focused on improving the capture of the high-quality care delivered at MGB. Under direct supervision of the Manager CDI Quality the CDI Quality Liaison will develop strategies to critically review records for appropriate clinical documentation related to quality indicators and outcomes including but not limited to Elixhauser and Vizient comorbidities Patient Safety Indicators (PSIs) and Hospital Acquired Conditions (HACs). The CDI Quality Liaison will have a deep understanding of the nature of quality reporting and how clinical documentation affects these areas. The CDI Quality Liaison will work closely with the Coding and Quality departments to adhere to a pre-bill reconciliation process and facilitate collaboration to enable a clinical focus on identified quality initiatives.

Principal Duties and Responsibilities

Perform CDI mortality reviews post coding and prebill
Develop strategies to critically review records for appropriate clinical documentation related to quality indicators and outcomes including but not limited to Elixhauser and Vizient comorbidities Patient Safety Indicators (PSIs) and Hospital Acquired Conditions (HACs)
Promote improvement initiatives directed at system-wide quality indicators (i.e. PSIs HACs) and clinical evidence to support appropriate DRG principal diagnosis and secondary diagnoses assignments
Develop and lead implementation of pre-bill reconciliation process for encounters that require clinical documentation improvement intervention related to quality measures and reporting
Provide ongoing monitoring and support for pre-bill reconciliation process
Serve as CDI Quality subject matter expert staying current with AHRQ Quality Indicator specifications CMS value-based care programs U.S. News and World Report Vizient and other quality reporting programs as needed
Assist with education and training for clinical and non-clinical staff across the MGB system around CDI-related quality initiatives and topics as needed
Support the analysis tracking trending and reporting of CDI related quality initiatives
Issue clinically credible and compliant queries to providers as appropriate with focus on addressing organizational quality initiatives
Accurately interpret clinical information in the health record evaluating clinical indicators to identify potential diagnoses and query opportunity
Communicate appropriately and compliantly either verbally in writing or by email with providers and/or members of the clinical team to improve health record documentation
Work collectively with RCO Coding Specialists and/or Quality team as related to supporting clinical documentation efforts to accurately reflect the quality of care being delivered at MGB
Meet with the physician advisors as needed
Maintain professional competency by keeping abreast of clinical advancements and coding guidelines on a yearly basis. Ongoing review of professional and coding literature.
Use the Mass General Brigham values to govern decisions actions and behaviors. These values guide how we get our work done: Patients Affordability Accountability & Service Commitment Decisiveness Innovation & Thoughtful Risk; and how we treat each other: Diversity & Inclusion Integrity & Respect Learning Continuous Improvement & Personal Growth Teamwork & Collaboration
Other duties as assigned

Education and Experience

• Associates Degree required
• Registered Nurse with a current license required
• 5 years of acute medical/surgical care nursing required
• 3 - 5 years of clinical documentation improvement experience quality management or related roles in a healthcare setting
• Certification in Clinical Documentation preferred
• Academic Medical Center experience preferred
• 2 - 3 years of experience with quality metrics regulatory compliance and clinical documentation processes preferred

Knowledge Skills and Abilities

• Familiarity with hospital coding practices quality reporting systems and regulatory standards (e.g. CMS Joint Commission).
• Strong understanding of clinical documentation requirements and quality care metrics.
• Proficient in data analysis and report generation to track quality outcomes and documentation accuracy.
• Attention to detail with the ability to identify documentation gaps and implement corrective actions.
• Strong organizational skills with the ability to manage multiple tasks and meet deadlines.
• Demonstrate a thorough knowledge of hospital quality measures reporting and the impact of CDI on quality outcomes
• Demonstrate a clear understanding of clinical and operational workflows within a CDI program
• Maintain a high proficiency and understanding of CDI initiatives encompassing basic through advanced CDI knowledge and skills
• Demonstrate a thorough understanding of regulatory compliance associated with CDI
• Basic knowledge of ICD-10 coding/classification systems appropriate for the inpatient prospective payment system
• Ability to analyze and interpret data to strategically drive efforts for improved outcomes
• Possess strong people skills to effectively communicate with cross functional teams including clinical and non-clinical staff at all levels of the organization
• Self-directed and motivated to function both independently and collaboratively
• Ability to successfully negotiate and collaborate with others of different skill sets backgrounds and levels within and external to the organization
• Strong problem solving and negotiation skills
• Ability to effectively conduct meetings both formal and informal
• Requires minimal direction from leadership and possesses the ability to learn quickly

Remote

399 Revolution Drive

40

Regular

Day (United States of America)

Pay Range

$79560.00 - $115720.80/Annual

Grade

7

At Mass General Brigham we believe in recognizing and rewarding the unique value each team member brings to our organization. Our approach to determining base pay is comprehensive and any offer extended will take into account your skills relevant experience if applicable education certifications and other essential factors. The base pay information provided offers an estimate based on the minimum job qualifications; however it does not encompass all elements contributing to your total compensation addition to competitive base pay we offer comprehensive benefits career advancement opportunities differentials premiums and bonuses as applicable and recognition programs designed to celebrate your contributions and support your professional growth. We invite you to apply and our Talent Acquisition team will provide an overview of your potential compensation and benefits package.

0100 Mass General Brigham Incorporated is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race color religious creed national origin sex age gender identity disability sexual orientation military service genetic information and/or other status protected under law. We will ensure that all individuals with a disability are provided a reasonable accommodation to participate in the job application or interview process to perform essential job functions and to receive other benefits and privileges of employment. To ensure reasonable accommodation for individuals protected by Section 503 of the Rehabilitation Act of 1973 the Vietnam Veterans Readjustment Act of 1974 and Title I of the Americans with Disabilities Act of 1990 applicants who require accommodation in the job application process may contact Human Resources at .

Mass General Brigham Competency Framework