Clinical Documentation Specialist (RN) FT Days in Shawnee Mission, KS at Shawnee Mission Medical Center

Date Posted: 8/18/2018

Job Snapshot

  • Job Schedule
  • Job Category
  • Date Posted:
  • Job ID:
  • Job Function
    Quality/Clinical Effectiveness
  • Travel
  • Shift
    1 - Day
  • AHS Zone
    1-Shared Services
  • Organization
    Shawnee Mission Medical Center

Job Description


Work Hours/Shifts

FT / Days

Shawnee Mission Health

SMH has provided faith-based, whole person care to the Kansas City community since 1962. SMH is more than just a hospital campus. We’re a network of health care facilities working to exceed expectations by delivering quality care with compassion and supporting an exceptional staff of more than 700 physicians representing 50 medical specialties.

Our mission of Improving Health Through Christian Service is achieved each and every day through the dedication and commitment of our associates, physicians and volunteers. We strive to be a regional beacon of wellness, hope and healing attracting customers seeking unsurpassed clinical quality and compassionate care for the whole person, following the example of Christ's healing ministry.

The largest health care provider in Johnson County, Kansas, the SMH network includes Shawnee Mission Medical Center, SMH – Overland Park and SMH – Prairie Star. The 54-acre campus at SMMC is comprised of the main hospital, a community health education building, six physician office buildings and an associate child care center. The Emergency Department at SMMC is the busiest in Johnson County. We deliver more babies each year at the Shawnee Mission Birth Center than any other hospital in the metropolitan area and our Center for Women’s Health is nationally recognized. We have 10 Shawnee Mission Primary Care locations with more than 70 Board-certified doctors who specialize in family medicine, internal medicine and pediatrics as well as Centra Care Shawnee Mission Urgent Care and Spira Care locations.

You will be responsible for:
  • Utilizes the Performance Improvement Model
  • Utilizes excellent interpersonal skills to deal with challenging situations while maintaining strong supportive relationships. Readily available for questions; handles requests in a courteous and respectful manner.
  • Communicates effectively, both written and verbally.
  • Demonstrates a proactive attitude and seeks to remedy situations before mistakes are made or corrects errors when found; takes responsibility for the overall “quality image” of the department.
  • Ensures accuracy of data collection and submission; validates integrity of data collected.
  • Develops data reports for projects, committees, hospital departments, medical staff departments, as designated.
  • Knowledge of and utilizes statistical approaches, measurement techniques, including benchmark and comparative data to develop quality reports.
  • Collects, aggregates, analyzes, summarizes and reports quality data for hospital organizational performance and physician performance data as indicates. 
  • Participates in hospital-wide outcomes and quality improvement initiatives/ performance improvement teams.
  • Assists in efforts to improve and streamline the process and workflow of the department.
  • Demonstrates the ability to set appropriate priorities.
  • Recognizes how absence impacts the functioning of the healthcare team and strives to minimize this effect.
  • When requested, is willing to adjust personal schedule in order to complete workload when necessary
  • Attends educational offerings as needed to promote continuous learning and support to department
  • Exhibits a thorough knowledge of clinical documentation issues, MS-DRG assignments, severity of illness (CC’s and MCC’s), Present on admission (POA’s), Hospital Acquired Conditions (HACs) and clinical conditions and treatments.
  • Reviews and applies analytical skills to designated patient population medical record documentation to assess the level of documentation accuracy and completeness.
  • Assists to identify the most appropriate principal diagnosis and co-morbidities to accurately reflect several of illness in compliance
  • Assigns and monitors DRG assignment to appropriately reflect the accurate severity at admission and throughout hospital stay.
  • Addresses missing, conflicting, or incomplete documentation issues by following up with providers when needed.
  • Facilitates modification to the clinical documentation supporting the clinical picture/level of severity rendered to all patients at the hospital.
  • Assesses documentation for areas of needed improvement and addresses with provider in a timely manner.
  • Collaborates with HIM staff to enhance their understanding of documentation resulting in appropriately assigning the DRG representing the patient severity of illness, presence of complications.
  • Assess needs of providers and creates collaborative action plans for improvement where needed.
  • Adjusts schedule and approach to best meet the needs of the providers.
  • Communicates timely and cooperatively with HIM staff on needed feedback.
  • Develops and provides educational sessions for providers when appropriate.
  • Through collaboration with AHS, HIM, and Management, documents and analyzes data and develops reports as needed to assist in the review and analysis of data to identify opportunities for improvement.
  • Works cooperatively with physicians and other providers to assure integrity of clinical documentation.
  • Utilizes CDI software and documentation of work product is consistent with goals of the department and AHS.
  • Documentation of CDI efforts are clear, concise, and complete.  
What will you need?
  • Bachelor’s Degree in Nursing
  • 1 to 2 Years of Position-Related Experience
  • RN Clinical Experience
  • Kansas Registered Nurse License
  • Certified Clinical Documentation Specialist - preferred

This facility is an equal opportunity employer and complies with federal, state and local anti-discrimination laws, regulations and ordinances.

Location | Organization | Category | Job Function