Help us maintain the quality of our job listings. If you find any issues with this job post, please let us know.
Select the reason you're reporting this job:
A $23 billion health care provider and insurer, Pittsburgh-based UPMC is inventing new models of patient-centered, cost-effective, accountable care. The largest nongovernmental employer in Pennsylvania, UPMC integrates 92,000 employees, 40 hospitals, 700 doctors’ offices and outpatient sites, and a 4 million-member Insurance Services Division, the largest medical insurer in western Pennsylvania. In the most recent fiscal year, UPMC contributed $1.4 billion in benefits to its communities, including more care to the region’s most vulnerable citizens than any other health care institution, and paid more than $800 million in federal, state, and local taxes. Working in close collaboration with the University of Pittsburgh Schools of the Health Sciences, UPMC shares its clinical, managerial, and technological skills worldwide through its innovation and commercialization arm, UPMC Enterprises, and through UPMC International. U.S. News & World Report consistently ranks UPMC Presbyterian Shadyside among the nation’s best hospitals in many specialties and ranks UPMC Children’s Hospital of Pittsburgh on its Honor Roll of America’s Best Children’s Hospitals. For more information, go to UPMC.com.
UPMC Corporate Quality is hiring a Data Abstractor- At Home to join our team! This position will work Monday through Friday during daylight hours. The position is a fully remote opportunity.
Under the direction of the Senior Manager, Supervisor, and Data Validation Coordinator, the Data Abstractor - At Home will conduct a comprehensive and systematic review of patient medical records for the purpose of extracting key elements for use in quality data reporting as required by the Centers for Medicare & Medicaid Services (CMS), state and Federal agencies, and other Value-Based Care incentive programs. Timely and accurate data capture and submission is essential to avoid a negative financial impact on the organization.
The Data Abstractor will identify and communicate variances to the Data Validation Coordinator, Supervisor and/or Sr. Manager for timely resolution within the health system. Scope of the Data Abstractor - At Home: Manage the overall medical record data retrieval process by collecting numerous complex data elements. This is done specific to measure format, by manual abstraction of the electronic health record (EHR) and/or validation of accurate electronic data capture. This requires having knowledge of multiple specification manuals, using established definitions for each measure element, and applying noted inclusions/exclusions for each measure.
The data retrieval process also requires the Data Abstractor - At Home to ensure the integrity of the electronic data capture by validating the CMS electronic Clinical Quality Measures (eCQM) by identifying, tracking, reporting electronic data capture errors to begin technical resolution and to identify clinical documentation and/or workflow issues for improving clinical quality reported outcomes. The role translates clinical documentation into information that is used for actionable improvement, to recognize and identify variances between system applications, and to evaluate potential causes of clinical documentation variation. This position works collaboratively to support plans for clinical care improvement.
Do you have prior experience with abstracting and possess skills in anatomy along with physiology? If so, this could be the next step in your career. Apply today!
Responsibilities:
Responsible for collection, review, and validation of patient level data, including but not limited to, national clinical quality initiatives such as the CMS programs for Inpatient (IP) Quality Reporting (IQR) that includes electronic Clinical Quality Measures (eCQMs), Outpatient (OP) Quality Reporting (OQR), Inpatient Psychiatric Facility Quality Reporting (IPFQR), all of which are required to financially maintain the CMS Annual Payment Update (APU), also known as the Market Basket Update, for UPMC hospitals.
Responsible for required data capture for the Joint Commission Accreditation and Certification programs, in addition to the American Heart Association (AHA)-Get with the Guidelines (GWTG)-Stroke programs.
Demonstrates a service-oriented approach by conveying courtesy, respect, enthusiasm, and a positive attitude for work responsibilities? Shows initiative and offers assistance to all department customers and UPMC Health System personnel in the completion of the department's goals.
Patient care issues and inter-departmental services are the priority of this position while protecting confidentiality of all patients related information.
Responsible for Technical, Measure Specifications, and Clinical Knowledge
Maintains a strong knowledge base of the CMS Quality Measure Specifications with each new version through continuous maintenance of the glossary, webinars, and continuous education for Inpatient, Outpatient & Electronic data collection.
Maintains a strong knowledge of the current AHA/GWTG Stroke Specifications for Primary/Comprehensive/Acute Stroke Ready Stroke Center facilities.
Able to use Excel and Spreadsheets to filter/sort data for trending and analysis use
Able to review and interpret work lists daily
Independently able to think through and combine technical and clinical documentation requirements
? Participates in ongoing assessment of electronic data sources? Able to identify and report EHR changes to Coordinator for team learning and knowledge? Evaluates data abstraction software performance, relating to accurate data capture, to detect potential system issues? Able to perform mathematical calculations as required in specifications? Able to read and interpret CMS Specification Manuals and workflow processes, in addition to other necessary manuals and workflows
? Needs to consistently keep up with multiple IP, OP, Stroke, eCQM, other specification manuals with bi-annual/annual revisions and maintain 95% accuracy ? IP & OP Abstraction: Reviews clinical documentation and extracts the key data elements as defined in the CMS Specifications ? eCQM Abstraction: Reviews electronic documentation and electronic fields defined by the CMS electronic Clinical Quality Measure Specifications
? Understands and follows complex workflow processes for accurate data capture in the UPMC EHR/Electronic Health Record? Accuracy of the required submitted data is directly related to CMS program revenue and full APU; CMS CDAC/Clinical Data Abstraction Center Audits are done quarterly to validate accuracy? AHA/GWTG Stroke Certification manual with three layers: ASR/Acute Stroke Ready, PSC/Primary Stroke Center, CSTK/Comprehensive Stroke
? Reviews clinical documentation and extracts key data elements according to the AHA/GWTG Specifications to maintain certification for Comprehensive, Primary, and Acute Stroke Ready Stroke Centers? As required by The Joint Commission, maintains an 80% (95% UPMC Team goal) Stroke accuracy rate for internal bi-annual validation audits through applied abstraction skills within the AHA/GWTG Stroke Registry? Accuracy of AHA/GWTG Stroke Abstraction links directly to each UPMC Stroke hospital and their Award of Gold/Bronze/Silver for excellence in patient care and clinical standards (AHA and Joint Commission)
? Expert (or can progress to expert) in EHR documentation location for accurate and most appropriate clinical data capture? Understands clinical terminology to accurately apply to date capture? Able to communicate with UPMC Cerner IT/Information Technology regarding clinical data reports? Analyzes and monitors the electronic medical record and identifies the required medical and/or surgical documentation through various electronic systems: MARS, Medipac, billing system, Cerner, HPF, etc., as applicable
? Recognizes and reports discrepancies found in the medical record to alert upstream clinical users as appropriate (Data Validation Coordinators, Supervisor, Sr. Manager, Quality Team(s), and Stroke Team(s)? Attends UPMC Departmental and System meetings, training/educational webinars as required. ? Reviews, edits, completes PHC4 Error Report as per their Director, Sr. Manager, Supervisor, or Data Validation Coordinator.
? Adheres to department productivity standards. Communicates any barriers affecting expected standards and works collaboratively with management team to meet department abstraction goals. Maintains and submits weekly a Daily Productivity Log of activities to the Coordinator/Manager/Supervisor. ? Adapts to changes in the work environment and process change, as necessary, and prioritizes work with the assistance of the Data Validation Coordinator, Supervisor, Sr. Manager or Director.
? Participates in training and orientation of new employees regarding the electronic record, clinical documentation, abstraction guidelines, and validation processes. ? Balance team and individual responsibilities while contributing to building a positive team spirit. ? Performs in accordance with system-wide competencies/behaviors. ? Performs other duties as assigned.
Required:
A high school graduate with a minimum of one to two years of clinical or quality measure abstracting experience OR CMS, AHA, and TJC abstracting experience between 2015 to present calendar year OR completion of a certified nurse assistant certificate program.
A strong knowledge in anatomy, physiology, pharmacology, and medical terminology is required.
Good written and oral communication and organizational skills is required.
Must possess high degree of concentration to accurately apply measure specifications to abstract data from patient records.
Must be detail oriented to assure accuracy of abstracted data and be able to identify issues within the systems used for abstracting.
Must demonstrate ability to work under pressure in a positive team-oriented manner with diplomacy and tact.
Computer skills of Microsoft Office applications and Internet use are required.
Preferred:
Cerner or similar clinical e-record system.
Knowledge of CMS IQR, OQR, IPFQR quality measure reporting program abstraction; AHA/GWG Stroke abstraction, and CMS eCQM program preferred.
A graduate of an approved accredited Registered Health Information Technician Program (RHIT or eligible) is preferred but not required.
Licensure, Certifications, and Clearances:
Act 34
UPMC is an Equal Opportunity Employer/Disability/Veteran
Annual
Required profile
Experience
Level of experience:Expert & Leadership (>10 years)
Spoken language(s):
English
Check out the description to know which languages are mandatory.