Clinical Documentation and Utilization Review Specialist (RN) - Population Health

Are you a highly skilled and compassionate Registered Nurse looking for a challenging role in population health? Look no further than Saint Francis Health System! We are seeking a dedicated Clinical Documentation and Utilization Review Specialist to join our team and play a critical role in ensuring quality patient care and optimizing healthcare utilization. In this role, you will work closely with interdisciplinary teams to review and analyze patient data, identify areas for improvement, and implement strategies to enhance population health outcomes. If you have a strong background in clinical documentation and utilization review, as well as a passion for promoting wellness and disease prevention, we want to hear from you! Join us in our mission to provide exceptional care and make a positive impact on the health of our community.

1. Review and analyze patient data to identify opportunities for improvement in population health outcomes.
2. Collaborate with interdisciplinary teams to develop and implement strategies to enhance patient care and optimize healthcare utilization.
3. Conduct thorough clinical documentation review to ensure accuracy and completeness of patient records.
4. Identify and address any deficiencies in documentation, working closely with healthcare providers to improve overall documentation practices.
5. Stay up-to-date on industry best practices and regulations related to clinical documentation and utilization review.
6. Educate and train healthcare providers on proper documentation practices to ensure compliance with regulatory standards.
7. Utilize data and analytics to identify trends and patterns in patient care and make recommendations for improvement.
8. Work closely with insurance companies and other payers to ensure accurate and timely reimbursement for services provided.
9. Maintain confidentiality and adhere to HIPAA regulations in all aspects of the job.
10. Serve as a resource and mentor to other team members, providing guidance and support in clinical documentation and utilization review.
11. Participate in quality improvement initiatives and provide input for developing and implementing new processes and procedures.
12. Act as a liaison between healthcare providers, patients, and insurance companies to resolve any issues related to documentation and utilization.
13. Advocate for patient wellness and disease prevention through effective utilization review and population health strategies.
14. Maintain accurate and detailed records of all documentation and utilization review activities.
15. Collaborate with other healthcare organizations to share best practices and improve overall population health outcomes.

According to JobzMall, the average salary range for a Clinical Documentation and Utilization Review Specialist (RN) - Population Health in New Haven, CT 06520, USA is $75,000 - $90,000 per year. This may vary depending on factors such as experience, education, and specific job responsibilities.

Saint Francis Health System is an integrated health system in Tulsa, Oklahoma, with an emphasis on a complete continuum of care. With more than 10,000 employees, 1,000 physicians and 90 locations, Saint Francis Health System provides the community's largest network of healthcare services.