Before you apply
FY2024 · Form 990Independent: from IRS data, not the orgAbout the role
The org's own posting, as writtenWelcome to Montage Health’s application process!
Job Description
The Clinical Documentation Integrity (CDI) Specialist - Physician Education & DRG Integrity is an in-house, concurrent documentation role responsible for working directly with physicians, advanced practice providers, HIM coding, quality, case management, and revenue cycle leadership to improve the accuracy, completeness, and clinical integrity of inpatient documentation.
This position works elbow-to-elbow with physicians and care teams to help identify the working DRG on day one of admission, improve documentation of the principal diagnosis and clinically relevant secondary diagnoses, and reduce the need for retrospective queries through real-time collaboration, education, and trend-based intervention. The role is designed to support the development of a fully internal inpatient CDI program and aligns with Vizient/Kaufman Hall recommendations related to program structure, workflows, and governance.
Experience
Required Minimum 3-5 years of acute care hospital experience in Clinical Documentation Integrity (CDI), inpatient coding, Health Information Management (HIM), case management, utilization management, quality improvement, or related clinical operations. Minimum 3 years of concurrent inpatient CDI experience performing documentation reviews, provider education, and compliant documentation clarification activities. Minimum 3 years of inpatient coding experience with demonstrated knowledge of ICD-10-CM/PCS coding, MS-DRG assignment, principal diagnosis selection, CC/MCC capture, and coding compliance requirements.
Demonstrated experience collaborating directly with physicians, advanced practice providers, coding professionals, and interdisciplinary teams. Strong working knowledge of: MS-DRG reimbursement methodology ICD-10-CM/PCS coding principles Principal and secondary diagnosis assignment Severity of Illness (SOI) and Risk of Mortality (ROM) Clinical indicators and clinical validation Query compliance standards Documentation requirements impacting quality, reimbursement, denials, and regulatory reporting Preferred Physician-facing CDI or Physician Documentation Liaison experience.
Experience providing physician education related to clinical documentation, coding, quality metrics, and DRG optimization. Experience with CDI analytics, reporting, and performance improvement initiatives. Experience supporting CDI program implementation, insourcing, or optimization efforts. Experience utilizing Epic, CDI technology platforms, and coding workflow tools. Education, Licensure & Certifications Required: California RN license for candidates qualifying through the RN pathway. RN Licensure Clarification: This position performs CDI/HIM functions and does not include direct patient care or the practice of nursing.
Candidates qualifying through the RN pathway may hold an active, unrestricted RN license from any U.S. state. CCS or CCS-P Preferred: CCDS (Certified Clinical Documentation…
About Aspire Health Plan
From its Form 990- Budget $146M · Health Care
- Staff 88 · founded 2012
- Pays its leaders $232K–$442K (5 reported)
- Open jobs 85 · Jobs at Aspire Health Plan · Full 990 report