Northeast Georgia Health System

Utilization Management and Clinical Documentation Improvement Director - RN Required

Northeast Georgia Health System(3 months ago)

Gainesville, GAOnsiteFull TimeDirector$110,521 - $150,439 (estimated)Utilization Management and Clinical Documentation Improvement
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About this role

The Director of Utilization Management (UM) and Clinical Documentation Improvement (CDI) leads UM and CDI functions at Northeast Georgia Medical Center, ensuring clinical documentation integrity and appropriate utilization of hospital resources. The role focuses on optimizing reimbursement, minimizing denials, and improving case mix index to support financial and clinical performance. This position acts as a liaison between clinical and financial teams and partners with hospital leadership and physicians to align documentation and utilization strategies system-wide.

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Required Skills

  • Leadership
  • Budget Management
  • Physician Education
  • Data Analysis
  • KPI Tracking
  • Coding
  • DRG Reimbursement
  • Case Management
  • Revenue Cycle
  • Performance Improvement

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Qualifications

  • Bachelor's Degree in Nursing
  • Registered Nurse License (Georgia)
  • Master's Degree in Nursing (Preferred)
  • CCM (Preferred)
  • ACM (Preferred)
  • CPUR (Preferred)
  • CDI/Coding Certification (Desirable)
Northeast Georgia Health System

About Northeast Georgia Health System

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Northeast Georgia Health System (NGHS) is dedicated to improving the health and quality of life of the people of Northeast Georgia.

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