Registered Nurse Clinical Documentation Quality Liaison Full Time Days
Location: Tampa, Florida
Internal Number: 21036703
Clinical Documentation Quality Liaison AdventHealth Tampa
Location Address:3100 East Fletcher Avenue Tampa, Florida 33613
Top Reasons to Work at AdventHealth Tampa
AdventHealth Pepin Heart Institute, known across the country for its advances in cardiovascular disease prevention, diagnosis, treatment, and research.
Surgical Pioneers – the first in Tampa with the latest robotics in spine surgery
Building a brand new, six story surgical and patient care tower which will ensure state of the art medical and surgical car for generations to come
Awarded the Get with The Guidelines – Stroke GOLD Quality Achievement Award from the American Heart Association/American Stroke Association and have been recognized as a recipient of their Target: Stroke Honor Roll for our expertise in stroke care. We have also received certification by The Joint Commission in collaboration with the American Stroke Association as a Primary Stroke Center.
You Will Be Responsible For:
Demonstrates, through behavior, Integrity, Compassion, Balance, Excellence, Stewardship, and Teamwork
Review’s mortality reviews and quality audits to ensure the ROI/SOM scores are appropriate and consistent in documentation of care delivered. Quality audits consist of but not limited to concurrent, mortality, Iodine Retrospect and other internal CDI audits to ensure compliance to guidelines.
Completes accurate and timely record review to ensure the integrity of documentation compliance. Completes accurate and concise input of data into Iodine resulting in accurate metrics provided by the Iodine metrics. Understands and supports documentation strategies (upon completion of training) and continues to educate self and team members using educational tools, videos and provided WebEx’s.
Recognizes opportunities for documentation improvement using strong critical-thinking skills. Uses critical thinking and sound judgment in decision making keeping reimbursement considerations in balance with regulatory compliance. Initiates/formulates Iodine severity worksheets and clinically credible clarifications for inpatients, sending/presenting opportunities for improved documentation compliance to physicians, nurse practitioners and other medical staff.
Transcribes documentation clarifications as appropriate for SOI, ROM, PSI, HCCs and HACs to ensure documentation compliance is accomplished.
What You Will Need:
Minimum of five years acute care nursing experience with specific medical/surgical, Intensive Care, post-acute care unit, or Emergency Department experience.
BSN (MSN preferred)
3-5 years Clinical Documentation Specialist experience
Current active State license as a Registered Nurse, Nurse Practitioner, or Physician’s Assistant
Under general supervision of the Director of Clinical Documentation Integrity and in some situations the supervision of the Clinical Documentation Integrity Manager, and in collaboration with physicians, nursing and HIM coders, the Clinical Documentation Quality Auditor Manager strategically facilitates and obtain appropriate and quality physician documentation for any clinical conditions or procedures to support the appropriate severity of illness, expected risk of mortality, and complexity of care of the patient. The Clinical Documentation Quality Auditor Manager educates members of the patient care team regarding documentation guidelines, including attending physicians, allied health practitioners, nursing, care management and quality abstracters. The Clinical Documentation Quality Auditor Manager adheres to strict departmental and organizational goals, objectives, standards of performance and policies and procedures, continually ensuring quality documentation and regulatory compliance. Actively participates in outstanding customer service and accepts responsibility in maintaining relationships that are equally respectful to all.
At AdventHealth, Extending the Healing Ministry of Christ is our mission. It calls us to be His hands and feet in helping people feel whole. Our story is one of hope — one that strives to heal and restore the body, mind and spirit. Our more than 80,000 skilled and compassionate caregivers in hospitals, physician practices, outpatient clinics, urgent care centers, skilled nursing facilities, home health agencies and hospice centers are committed to providing individualized, wholistic care.