RN - Senior Clinical Documentation Specialist - Utilization Management

Sanford Health is one of the largest and fastest-growing not-for-profit health systems in the United States. We’re proud to offer many development and advancement opportunities to our nearly 50,000 members of the Sanford Family who are dedicated to the work of health and healing across our broad footprint. 

Work Shift:

8 Hours - Day Shifts (United States of America)

Scheduled Weekly Hours:

40

Salary Range: $31 - $49.50

Union Position:

No

Department Details

Remote Work Flexibility: Enjoy the option to work remotely, offering a better work-life balance while still being an integral part of a high-performing healthcare team.

Collaborative & Dynamic Team: Work alongside a knowledgeable, supportive, and forward-thinking clinical documentation team that values collaboration and continuous improvement.

Progressive, Patient-Centered Organization: Sanford Health is committed to innovation and excellence, with a strong focus on improving patient outcomes through accurate and complete clinical documentation.

Career Development Opportunities: Access professional development resources and opportunities to grow within one of the largest and most respected rural health organization

Summary

At an advanced level, communicates with physicians, case managers, coders, and other healthcare team members to facilitate comprehensive medical record documentation to reflect clinical treatment, decisions, and diagnoses for inpatients/residents.

Job Description

Utilizes designated clinical documentation system to identify opportunities for physician and outcomes, provides or coordinates education to all internal customers related to compliance, coding, and clinical documentation issues and acts as a consultant to coders when additional information or documentation is needed to assign the correct diagnosis related group (DRG). Responsible for the day-to-day evaluation of documentation by the medical staff and healthcare team in accordance with the designated clinical documentation system, and gathers and analyzes information pertinent to documentation findings and outcomes.

Must possess advanced communication and interpersonal skills with all levels of internal and external customers. Must demonstrate excellent written/verbal communication, critical thinking, creative problem solving, and conflict management skills. Must be proficient in organization and planning. Must possess strong computer skills including the use of spreadsheets, presentation programs, word processing, and Internet searching. Must demonstrate working knowledge of
quality improvement theory and practice. Must have working knowledge of DRGs and medical necessity criteria. Knowledgeable of Federal, State, and other payers' regulations, requirements, and criteria.

Qualifications

Graduate from a nationally accredited nursing program preferred, including, but not limited to, Commission on Collegiate Nursing Education (CCNE), Accreditation Commission for Education in Nursing (ACEN), and National League for Nursing Commission for Nursing Education Accreditation (NLN CNEA). Bachelor's degree in nursing is preferred.

Must have a minimum of five years of clinical practice. Knowledge and experience in case management, utilization management and/or Coding highly preferred.

Currently holds an unencumbered RN license with the State Board of Nursing where the practice of nursing is occurring and/or possess multistate licensure if in a Nurse Licensure Compact (NLC) state. Obtains and subsequently maintains required department specific competencies and certifications.

Sanford is an EEO/AA Employer M/F/Disability/Vet. 

If you are an individual with a disability and would like to request an accommodation for help with your online application, please call 1-877-673-0854 or send an email to talent@sanfordhealth.org.