Sr. Clinical Report Auditor

Discover Vanderbilt University Medical Center:  Located in Nashville, Tennessee, and operating at a global crossroads of teaching, discovery, and patient care, VUMC is a community of diverse individuals who come to work each day with the simple aim of changing the world. It is a place where your expertise will be valued, your knowledge expanded, and your abilities challenged. Vanderbilt Health recognizes that diversity is essential for excellence and innovation. We are committed to an inclusive environment where everyone has the chance to thrive and where your diversity of culture, thinking, learning, and leading is sought and celebrated. It is a place where employees know they are part of something that is bigger than themselves, take exceptional pride in their work and never settle for what was good enough yesterday. Vanderbilt’s mission is to advance health and wellness through preeminent programs in patient care, education, and research.

Organization:

CPPA Operations - Sebes

Job Summary:

JOB SUMMARY
Reviews and audits patient complaint and co-worker observation records for the purpose of applying principles of the CPPA coding manuals, independently. Performs analysis to components of care as described in complaint records. Determines the correct attribution of patient complaint text to identified professionals along with validity of attribution of patient complaint records based on medical knowledge or expertise.

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KEY RESPONSIBILITIES
• Participates in the review, editing and analysis of patient complaints and co-worker observations in according with prescribed CPPA coding manuals and intervention material production.
• Assigns the code that most appropriately reflects documentation of the occurrence of events and resources utilized during the patient encounter.
• Reviews documentation to ensure assigned codes are supported, recognizes documentation clarification opportunities and works with team to secure additional documentation.
• Writes explanations to support or rebut coding recommendations.
• Participates in accurate data collection, analysis, evaluation, problem solving and recommendations of process improvements.
• Performs pre-intervention reviews and qualitative reviews.
• The responsibilities listed are a general overview of the position and additional duties may be assigned.

TECHNICAL CAPABILITIES
• Quality Assurance (Advanced): Understands the goal of increasing organizational productivity and individual performance by making the products and services within your work assignments more efficient and more effective.
• Communication of Results (Advanced): Communicates results and recommendations to customers in a concise and non-technical format. Clearly states implications and potential next steps. Presents analysis, ideas, and findings using the appropriate data visualization and presentation tools [such as Word, Excel, Tableau, and PowerPoint].
• Peer Leadership (Intermediate): The ability to show leadership and influence people of equal rank in an effort to accomplish team goals.
• Critical Thinking (Advanced): The objective analysis and evaluation of an issue in order to form a judgment.
• Data Analysis (Advanced): The ability to analyze data in an accurate manner.
• Process Improvement (Advanced): Identifies, analyzes and improves upon existing business processes for optimization and to meet standards of quality.

Our professional administrative functions include critical supporting roles in information technology and informatics, finance, administration, legal and community affairs, human resources, communications and marketing, development, facilities, and many more.

At our growing health system, we support each other and encourage excellence among all who are part of our workforce. High-achieving employees stay at Vanderbilt Health for professional growth, appreciation of benefits, and a sense of community and purpose.

Core Accountabilities:

Organizational Impact: Independently delivers on objectives with understanding of how they impact the results of own area/team and other related teams. Problem Solving/ Complexity of work: Utilizes multiple sources of data to analyze and resolve complex problems; may take a new perspective on existing solution. Breadth of Knowledge: Has advanced knowledge within a professional area and basic knowledge across related areas. Team Interaction: Acts as a "go-to" resource for colleagues with less experience; may lead small project teams.

Core Capabilities :

Supporting Colleagues: - Develops Self and Others: Invests time, energy, and enthusiasm in developing self/others to help improve performance e and gain knowledge in new areas. - Builds and Maintains Relationships: Maintains regular contact with key colleagues and stakeholders using formal and informal opportunities to expand and strengthen relationships. - Communicates Effectively: Recognizes group interactions and modifies one's own communication style to suit different situations and audiences. Delivering Excellent Services: - Serves Others with Compassion: Seeks to understand current and future needs of relevant stakeholders and customizes services to better address them. - Solves Complex Problems: Approaches problems from different angles; Identifies new possibilities to interpret opportunities and develop concrete solutions. - Offers Meaningful Advice and Support: Provides ongoing support and coaching in a constructive manner to increase employees' effectiveness. Ensuring High Quality: - Performs Excellent Work: Engages regularly in formal and informal dialogue about quality; directly addresses quality issues promptly. - Ensures Continuous Improvement: Applies various learning experiences by looking beyond symptoms to uncover underlying causes of problems and identifies ways to resolve them. - Fulfills Safety and Regulatory Requirements: Understands all aspects of providing a safe environment and performs routine safety checks to prevent safety hazards from occurring. Managing Resources Effectively: - Demonstrates Accountability: Demonstrates a sense of ownership, focusing on and driving critical issues to closure. - Stewards Organizational Resources: Applies understanding of the departmental work to effectively manage resources for a department/area. - Makes Data Driven Decisions: Demonstrates strong understanding of the information or data to identify and elevate opportunities. Fostering Innovation: - Generates New Ideas: Proactively identifies new ideas/opportunities from multiple sources or methods to improve processes beyond conventional approaches. - Applies Technology: Demonstrates an enthusiasm for learning new technologies, tools, and procedures to address short-term challenges. - Adapts to Change: Views difficult situations and/or problems as opportunities for improvement; actively embraces change instead of emphasizing negative elements.

Position Qualifications:

Responsibilities:

Certifications:

LIC-Registered Nurse - Licensure-Others

Work Experience:

Relevant Work Experience

Experience Level:

5 years

Education:

Bachelor's

Vanderbilt Health recognizes that diversity is essential for excellence and innovation. We are committed to an inclusive environment where everyone has the chance to thrive and to the principles of equal opportunity and affirmative action. EOE/AA/Women/Minority/Vets/Disabled