Spec Clin Doc Integrity Lead
uf health
Overview The CDS Lead performs concurrent and retrospective second level reviews on specific types of medical records and strategizes the approach and process refinements to capture opportunity within the CDS team (prioritization, assignment, etc.) The CDS lead will track the progress of the CDI team in capturing opportunities and prioritizing workload effectively along with developing and overseeing new hire training and the orientation program for new CDSs. The CDS Lead also provides documentation integrity education to CDI Specialists and physicians. Qualifications Required Education: Bachelor's degree in Nursing Preferred Education: MSN or PhD Required Licensure/Certifications: Licensed to practice nursing in the state of Florida Within four (4) years of hire or transfer must have one of the certifications below and the certification must be maintained. -Certified Clinical Documentation Specialist (CCDS) certification -Certified Documentation Improvement Practitioner (CDIP) Preferred Licensure/Certifications: CCDS, CDIP, CCS, or CCA Required Experience: 1-2 years previous CDI experience -OR- minimum of 5 years of acute care nursing experience with at least 3 of those years being surgical intensive care or ICU clinical experience. Preferred Experience: Nursing educator background. 5-10 years clinical ICU experience in large teaching facility with Level 1 Trauma Center. 2-5 years� experience with implementation and/or management of a Clinical Documentation Improvement Program. Necessary Skills: 1. Extensive clinical knowledge and understanding of pathology/physiology; best demonstrated by clinical experience in hospital setting 2. Strong critical thinking skills and the ability to review the medical record to identify information not yet documented but supported by clinical indicators or clinical clues 3. Knowledge of age-specific patient needs and the elements of disease processes and related procedures 4. Excellent written and verbal communication skills; ability to write concisely and effectively when communicating with providers Age of Patients Served: N/A
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