• Clinical Optimization Specialist

    Requisition ID
    Community Medical Centers - Corporate Offices (CMC)
    Posted Date
  • Overview

    The Clinical Optimization Specialist is a vital member of our mission.

    In this role you will be responsible for collaborating, consults, and advises clinicians, CDI specialists, informatics professionals, IT and other staff to implement clinical documentation practice and processes through analysis and interpretation of workflow. Conceptualizes the creation and implementation of service specific documentation standards. Facilitates and obtains appropriate physician documentation for any clinical conditions or procedures to support the appropriate severity of illness, expected risk of mortality and complexity of care of the patient. Educates members of the patient care team regarding documentation guidelines.


    Why are we the “Employer of first choice”?


    We provide a world of opportunity for professional growth and personal advancement by making the health and financial security of our employee’s a top priority. We embrace our responsibility to the people who make us the largest private employer in the central San Joaquin Valley by offering comprehensive and affordable medical benefits as part of your employment with CMC.  We value giving you a choice in your health coverage by providing three medical plan options.  You will also be offered prescription drug, dental and vision coverage, paid time off, flexible spending accounts, life and disability insurance, discounts on many goods and services, and an employer matched Tax Sheltered Annuity Plan (403(b)).

    Our team members enjoy additional benefits such as: education reimbursement, an employee gym, concierge service, and award winning cuisine. 

    Based in Fresno, California, we are a multi-specialty healthcare system comprised of four hospitals; Community Regional Medical Center, Clovis Community Medical Center, Fresno Heart & Surgical Hospital, Community Behavioral Health Center. Additionally, our system includes other health care facilities and a physician residency program in conjunction with the University of California, San Francisco. Our primary service area is 15,000-square-miles, and we're home to the only combined, burn and Level 1 trauma center between Los Angeles and Sacramento. 

    Community Medical Centers is an equal opportunity employer, Affirmative Action employer fully dedicated to achieving a diverse staff. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, veteran status, disability status, sexual orientation, gender identity, or any other protected status.

    If you are looking to make a difference and value a purposeful, lasting career, we provide that in our 120 year old hospital system! For more information on why you should choose Community please click the link:https://www.communitymedical.org/


    • Conceptualizes enhancements to clinical information systems to support operational needs and goals, including clinical revisions and approval of system changes.
    • Responsible for development and maintenance of CMC wide clinical documentation improvement, template design and problem list usage.
    • Completes review of medical records and HIM audits for identified patients in the required timeframe. Collaborates with hospital coding staff to ensure appropriate DRG and completeness of supporting documentation. Reviews records upon request to confirm DRG assignment or need to follow up with physician regarding incomplete documentation.
    • Continuously evaluates the quality of clinical documentation to find incomplete or inconsistent documentation for inpatient encounters that impact the code selection and resulting in DRG grouping and payment.
    • Completes concurrent and follow-up reviews of patient medical records within 24-48 hours of admission to evaluate documentation for principal diagnosis, pertinent secondary diagnoses and procedures for accurate DRG assignment, risk of mortality, and severity of illness. Determines inconsistencies in the documentation.
    • Queries physicians regarding missing, unclear, or conflicting health record documentation by requesting and obtaining additional documentation within the health record as needed.
    • Meets quality and productivity requirements as defined by Director.  
    • Communicates effectively one on one with physicians and builds rapport with medical staff, informatics and IT staff.


    Minimum required:

    Doctor of Medicine (MD) or Doctor of Osteopathic Medicine (DO) from an accredited medical school. Three to five years of progressively responsible experience in Clinical Documentation Improvement and Coding, teaching and training.


    Masters’ degree in Business, Health Care Management, Organizational Development, or related field. Three to five years of Performance Improvement experience. 



    Certified Clinical Documentation Specialist (CCDS) certification through the Association of Clinical Documentation Improvement Specialists (ACDIS) organization. 


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