Clinical Nurse Specialist jobs in Saint Cloud, MN

Alomere Health prides itself on delivering state-of-the-art care while upholding the values of a close-knit community. Joining the ranks of the Top 20 Rural Hospitals in the Nation, as recognized by The National Rural Health Association, Alomere Health stands out as the sole Minnesota hospital to achieve this prestigious distinction. As our community continues to expand, we seek dedicated caregivers who possess expertise and a heartfelt commitment to supporting individuals during their most vulnerable times.

Department:

Quality Improvement

FTE (Full Time Equivalent)

0.5 FTE (40 Hours per pay period)

Hours:

Monday thru Friday: Day Shift (Flexible day hours); possible weekend hours

Position Objective

The Clinical Documentation /Utilization Review Quality Specialist is responsible for essential documentation improvement analysis under the direction of the Director of Quality & Risk Management and UR/CDI Physician Advisor. This position will work with CDI and Utilization Review Software programs and directly query physicians. The program goal is to assist Providers with Concurrent Documentation to obtain complete and accurate documentation in the Medical Record. For UR, this position reviews patient charts to ensure patients meet medical necessity for hospitalization and are admitted into the correct admission status.

Essential Responsibilities

The following description of responsibilities to be performed is not intended to be all-inclusive. Rather, it focuses on the major tasks that must be accomplished.

• Perform CDI Reviews in accordance with 3M CDI training and meet all State & Federal Regulations
• Accountable for review of Medicare and Medicare Replacement Insurance reviews for Clinical Documentation Improvement and review additional cases as time allows
• Communicate directly to physicians and providers to improve documentation using CDIS
• Communicate directly to physicians when medical necessity meets, or does not meet insurance approval
• Assist in Quality (Abstracting) & Utilization Review when needed

Other Responsibilities

• Perform all other related duties as assigned in a professional and responsive manner
• Demonstrate the ability to use relevant equipment
• Support, understand, and promote Alomere Health’s mission, vision, values, policies and procedures
• Ability to meet the work schedule requirements with flexibility dependent upon the needs of the department
• Foster respectful working relationships with professional colleagues, patients, families, and general public regardless of age, gender, lifestyle, culture, beliefs, race, socioeconomic class, or ability

Required Qualifications

• Graduate of an LPN Nursing Program
• Two years of experience in healthcare
• Active and current registration in the state of Minnesota

Preferred Qualifications

• Experience or training in Clinical Documentation Improvement (CDI), Utilization Review or other Quality-related training

Knowledge, Skills and Abilities

• Attention to detail
• Critical Thinking Skill
• Problem Solving

Union Position:

No

Benefit Status:

Part-Time