CDI Second Level Reviewer

Overview Catholic Health is one of Long Island’s finest health and human services agencies. Our health system has over 16,000 employees, six acute care hospitals, three nursing homes, a home health service, hospice and a network of physician practices across the island. At Catholic Health, our primary focus is the way we treat and serve our communities. We work collaboratively to provide compassionate care and utilize evidence based practice to improve outcomes – to every patient, every time. We are committed to caring for Long Island. Be a part of our team of healthcare heroes and discover why Catholic Health was named Long Island's Top Workplace! Job Details The CDI Second Level Reviewer is an experienced Clinical Documentation Specialist responsible for performing advanced, targeted case reviews on potentially high-impact encounters. This role focuses on identifying documentation opportunities in complex or high-risk cases to ensure accurate representation of patient acuity, quality outcomes (such as expected mortality), and financial performance. This role serves as an escalation and quality layer beyond concurrent review. This role will coordinate closely with CDI leadership and the CDI Educator to identify trends and provide feedback to the concurrent review team on findings. Job Responsibilities Perform secondary reviews of cases with a high potential impact, including but not limited to:Length of stay variance from expected (GMLOS) without documented comorbiditiesLow acuity diagnoses with longer than expected length of stayUnexpected mortalities and hospice dischargesMortality risk variable opportunity casesOther quality reviews such as PSIs or HACsIdentify and act on missed documentation opportunities impacting severity, risk adjustment, and reimbursementSend queries to clarify documentation when appropriateDeliver feedback and education to concurrent CDI staff on findings in coordination with CDI Educator and/or CDI leadership Analyze trends and patterns to support quality and performance improvement initiativesPartner with CDI leadership to refine review criteria and escalation processesEnsure alignment with coding guidelines and organizational prioritiesCollaborate with coding and CDI Physician Advisors, as needed, on cases with potential opportunities identified in second level reviews Required Qualifications Licensed in NYS, RN, NP or PA who is a credentialed Clinical Documentation Specialist CCDS, or CDIPExperience – minimum of 5 years recent CDI experience.Demonstrated advanced CDI knowledge and strong clinical foundationProven experience in concurrent CDI reviewStrong understanding of DRG methodology, quality metrics, and documentation impactExcellent critical thinking and communication skillsPreferred Epic EMR and 3M 360 application proficiency Desired Attributes High level of clinical and coding expertiseAbility to identify nuanced documentation gaps in complex casesDetail-oriented with strong problem-solving skillsCollaborative mindset with ability to educate and influence peersComfortable working independently in a specialized review workflowStrong sense of accountability and ownership for high-impact work Deliverables Completion of timely, high-quality second-level reviews for prioritized casesIdentification and capture of documentation opportunities that impact quality and financial outcomesFeedback provided to CDI team based on review findings in coordination with CDI Educator and CDI leadershipContribution to improved documentation and quality metricsRegular reporting of trends, opportunities, and outcomes from second-level reviews Salary Range USD $145,000.00 - USD $180,000.00 /Yr. This range serves as a good faith estimate and actual pay will encompass a number of factors, including a candidate’s qualifications, skills, competencies and experience. The salary range or rate listed does not include any bonuses/incentive, or other forms of compensation that may be applicable to this job and it does not include the value of benefits. At Catholic Health, we believe in a people-first approach. In addition to the estimated base pay provided, Catholic Health offers generous benefits packages, generous tuition assistance, a defined benefit pension plan, and a culture that supports professional and educational growth.