Current UPMC employees must apply in HR Direct.

Lead, CDI Coding

Job ID: 6030639129
Status: Full-Time
Regular/Temporary: Regular
Shift: Day Job
Facility: UPMC Harrisburg
Department: Health Info-Admin-HBG
Location: 111 South Front Street, Harrisburg, PA
Union Position: No
Salary Range: $ 35.33-54.74 USD

This CDI Coding Lead is a hybrid opportunity that oversees CDI operations for UPMC Harrisburg and UPMC Community Osteopathic. The selected candidate would have the opportunity to work from home 3 days per week and select an on-site work location at the facility closest to their home for the remaining days. To ensure operations run smoothly, the selected candidate would be expected to visit each site they oversee once a month – to meet with staff and providers.

Supervise the staff performing CDI optimization for inpatients concurrently, as well as post coding DRG optimization, including the coordination of training/education related initiatives for the CDI program. Provide direction and coordination of the work flow among all necessary hospital groups/departments. Ensure accuracy and timely input of clinical documentation to support severity of illness and risk of mortality scores as well as optimal reimbursement by payers. Interact with physicians regarding clarifications necessary for appropriate coding and clinical documentation standards.

Responsibilities:

  • Adhere to human resource policies and procedures. Assist with the performance reviews for all direct reports.
  • Assist with the one-on-one education with staff identified as having quality or productivity related deficits based on audits conducted within the department. Conduct audits on staff to ensure quality indicators are met. Review findings with appropriate personnel.
  • Review work flow to maximize automated systems. Assist with training of new staff.
  • Coordinate all work distribution for CDI staff. Provide education and audit related feedback to enhance the coding knowledge base of all inpatient coding.
  • When necessary, complete CDI functions to ensure minimal backlogs exists.
  • Perform CDI related work duties (i.e., work CDI patient list and markers regularly to ensure work production requirements are met).
  • Perform duties and responsibilities in a fashion that coincides with the service management philosophy of UPMC including the demonstration of the basics of service excellence towards patients, visitors, staff, peers, physicians and other departments within the medical center.
  • Assist with CDI software program testing and marker evaluations, including providing feedback to vendor and medical director of coding. Investigate staff issues and provide feedback as appropriate on resolution.
  • Provide education related sessions on CDI requirements during staff meetings and other sessions as applicable, including physicians.
  • Assist with the development and implement policies and procedures for processes performed for the CDI program. Provide support, training, develop and guidance to staff in their daily activities.

Qualifications:

  • Three years of previous clinical documentation improvement specialist) AND 3 years of experience with the Prospective Payment System and DRG selection/assignment and optimization; Bachelor’s degree or equivalent years of experience in related field.
  • Knowledge of computer technology, quality assurance activities, DRG, Quality Insights/Utilization review background is highly preferred.
  • Strong experience with electronic documentation and electronic medical record content. Prior supervisory experience preferred Ability to communicate with staff, physicians, healthcare providers, and other health care system personnel in a professional and diplomatic manner required.

    Licensure, Certifications, and Clearances:

  • Certified Coding Specialist (CCS) OR Certified Professional Coder (CPC) OR Registered Health Information Administrator OR Registered Health Information Technician (RHIT) OR Registered Nurse (RN)
  • Act 34

*Current licensure either in the state where the facility is located or, if the facility is in a state covered by the multistate Nursing Licensure Compact (NLC) agreement, a multistate license issued by a participating NLC state. Hires and current employees working on an out-of-state NLC license who later change their residency to the state where the facility is also located will have 60 days upon changing their residency to apply for licensure within that state.

UPMC is an Equal Opportunity Employer/Disability/Veteran

CAREER GROWTH

Grow Your Nursing Career

Spanning over 20 clinical specialties and more than 50 unique nursing roles, every nurse at UPMC can achieve and advance their goals with the My Nursing Career Ladder. Whether you’re looking to progress to an elevated role or continue your education, UPMC equips nurses with the resources, feedback, leadership, and benefits to help you succeed and achieve your career goals. Here’s how a few nurses have grown their careers through the years at UPMC:

Clyde C.

As a Professional Staff Nurse, Expert at UPMC Muncy, Clyde is a great example of someone who has taken advantage of UPMC’s My Nursing Career Ladder to grow his career while remaining in the same hospital location.

Clyde’s Career Journey:

⦁ 2017: Professional Staff Nurse – UPMC Muncy
⦁ 2021: Sr. Professional Staff Nurse – UPMC Muncy
⦁ 2022: Sr. Professional Staff Nurse II – UPMC Muncy
⦁ 2022-present: Professional Staff Nurse, Expert – UPMC Muncy

Male nurse stands in front of hospital, smiling at the camera.

Michelle B.

In her current role as a Professional Staff Nurse, Expert at UPMC Presbyterian, Michelle cares for patients with chronic and ongoing health issues as part of a Medical-Surgical unit. Michelle enjoys the daily change that Med-Surg nursing brings, and has found a career path that is interesting, meaningful, and full of opportunity.

Michelle’s Career Journey:

⦁ 2019: Staff Nurse – UPMC Presbyterian
⦁ 2020: Professional Staff Nurse – UPMC Presbyterian
⦁ 2021: Professional Staff Nurse, BSN – UPMC Presbyterian
⦁ 2021: Sr. Professional Staff Nurse, BSN – UPMC Presbyterian
⦁ 2022: Sr. Professional Staff Nurse II, BSN – UPMC Presbyterian
⦁ 2023: Professional Staff Nurse, BSN, Expert – UPMC Presbyterian

Michelle, a blonde nurse, smiles at the camera outside of a hospital setting.

Jouli H.

Born in Syria, Jouli H. had a childhood dream of becoming a nurse. After moving to the United States and initially pursuing a different career, Jouli decided to return to school when she turned 30, returning to the hope and dream she had as a little girl. After attending UPMC Mercy School of Nursing, Jouli has continued her UPMC career journey, even becoming a mother along the way.

Jouli’s Career Journey:

⦁ 2020: Staff Nurse – UPMC Mercy
⦁ 2020: Professional Staff Nurse – UPMC Mercy
⦁ 2021: Professional Staff Nurse, BSN – UPMC Mercy
⦁ 2022: Professional Staff Nurse, BSN, Casual – UPMC Mercy
⦁ 2023: Sr. Professional Staff Nurse, BSN, Casual – UPMC Mercy

Jouli wears blue scrubs in a hospital room, looks at camera with a soft smile on her face.

Keshon B.

Keshon might have only started his nursing career 3 years ago, but he has made the most of his time at UPMC! Through tuition assistance and mentorship by coworkers, Keshon has gained experience and grown as a nurse, leader, and UPMC team member. Before his current role with UPMC Travel Staffing, Keshon proudly worked as a staff nurse in his hometown of McKeesport.

Keshon’s Career Journey:

⦁ 2020: Professional Staff Nurse – UPMC Presbyterian Shadyside
⦁ 2020: Professional Staff Nurse, BSN – UPMC Presbyterian Shadyside
⦁ 2020: Staff Nurse – UPMC McKeesport
⦁ 2020: Staff Nurse, BSN – UPMC McKeesport
⦁ 2021: Bed Flow Coordinator – UPMC McKeesport
⦁ 2022: Administrator On Duty – UPMC McKeesport
⦁ 2022-present: RN – UPMC Travel Staffing, MS

Keshon, a younger male nurse, wears blue scrubs in a hospital hallway, looks at camera with a soft smile on his face.

INSURANCE SERVICES DIVISION OF UPMC

Advance Your Future

A career with UPMC means more than just caring for patients – when you’re a part of UPMC Insurance Services Division, it means caring for more than four million insurance members, too. UPMC Insurance Services Division offers a full range of health insurance products and services to our network across the country, providing peace of mind, better health, and financial security to our members, along with limitless career opportunities and a rewarding mission to those on our team.

About UPMC Insurance Services Division

As an integrated health care provider-insurer, UPMC goes beyond patient care to provide insurance products and services to millions of members. Our team partners with UPMC and community network providers to deliver knowledge and expertise that provides the highest quality care at the most affordable price, supporting our members through service, communication, and more.

Fast Facts:

  • We provide insurance products and services to over more than four million members.
  • UPMC’s Insurance Services Division offers a full range of health insurance options including UPMC Health Plan, Workpartners, UPMC for Life, UPMC for You, UPMC for Kids, UPMC Community HealthChoices, and Community Care Behavioral Health.
  • UPMC Health Plan is among the nation’s fastest-growing health plans.

Opportunities on Our Team

We’ve got a job that’s just right for you! UPMC Insurance Services Division team offers a vast array of career paths and opportunities, from career areas like customer service, data analytics, and information technology and even patient care roles like social work, nursing, and care management.

Whether in non-clinical or patient-facing roles, our team impacts patients and members by providing quality experiences before, during, and after their care, building relationships in a unique and meaningful way.

Recognized for Excellence

Be a part of an award-winning team! UPMC Insurance Services Division has been recognized for outstanding care and service with awards that include:

  1. U.S. News and World Report named UPMC for Life a “Best Insurance Company for Medicare Advantage” in Pennsylvania for 2024.
  2. The Human Rights Campaign Foundation has named UPMC Health Plan an “Equality 100 Leader in LGBTQ+ Workplace Inclusion” for 2023–2024.
  3. UPMC for Life ranked #1 in Customer Satisfaction* among Medicare Advantage Plans in Pennsylvania by J.D. Power.
  4. The Ethisphere Institute named UPMC as one of the World’s Most Ethical Companies for the sixth consecutive year.

*Results are based on award-eligible plans in Pennsylvania by J.D. Power. For J.D. Power 2024 award information visit, jdpower.com/awards.

Jump-Start Your Career

Looking to launch a career with longevity and opportunity? With countless entry-level opportunities for recent graduates, along with tools and resources that empower you as you learn and grow, UPMC Insurance Services Division is the perfect place to get a career started.

Interested in taking your career to new heights? Our career paths and advancement opportunities will provide you with chances to achieve your goals at every step.

BENEFITS AND LIFE AT UPMC

Why Work Here

We know that you have many options when choosing where to build your career. So why choose UPMC? We can think of a few reasons.

Work-Life Balance

Finding the ideal balance to manage the important elements in your life.

Development & Opportunities

Enhancing your career through continued learning opportunities and/or advancement.

Compensation

Receiving competitive pay for the work that you do – base pay, merit, and premium pay.

Performance & Recognition

Rewarding performance that supports the goals and mission of UPMC.

Benefits

Providing assistance and security to meet the current and future needs of you and your family.

Work-Life Balance

Finding the ideal balance to manage the important elements in your life.

Development & Opportunities

Enhancing your career through continued learning opportunities and/or advancement.

Compensation

Receiving competitive pay for the work that you do – base pay, merit, and premium pay.

Performance & Recognition

Rewarding performance that supports the goals and mission of UPMC.

Benefits

Providing assistance and security to meet the current and future needs of you and your family.

Benefits that Matter to You

We’re committed to providing benefits that meet your needs and support your well-being in all areas of life.

  • Earn over 5 weeks of paid time off every year
  • Affordable medical, dental & vision coverage
  • Student loan assistance and tuition reimbursement options
  • Earn up to 8% of your eligible pay in retirement contributions from UPMC
  • Employer-paid life insurance

Benefits that Matter to You

We’re committed to providing benefits that meet your needs and support your well-being in all areas of life.

  • Earn over 5 weeks of paid time off every year
  • Affordable medical, dental & vision coverage
  • Student loan assistance and tuition reimbursement options
  • Earn up to 8% of your eligible pay in retirement contributions from UPMC
  • Employer-paid life insurance

Benefits that Matter to You

We’re committed to providing our employees with benefits that meet their needs and support their well-being in all areas of life.

  • Earn over 5 weeks of paid time off every year
  • Affordable medical, dental & vision coverage
  • Student loan assistance and tuition reimbursement options
  • Earn up to 8% of your eligible pay in retirement contributions from UPMC
  • Employer-paid life insurance

Support for You – and Your Family

Your career doesn’t impact just you, but the people you care about, too. We’re making sure your career works for the whole family.

  • Two weeks of paid parental leave
  • Family planning resources
  • Tuition assistance for dependents
  • Comprehensive health care for dependents
  • Emergency child and elder care options
  • Flexible work arrangements

Support for You – and Your Family

Your career doesn’t impact just you, but the people you care about, too. We’re making sure your career works for the whole family.

  • Two weeks of paid parental leave
  • Family planning resources
  • Tuition assistance for dependents
  • Comprehensive health care for dependents
  • Emergency child and elder care options
  • Flexible work arrangements

Support for You – and Your Family

Your career doesn’t impact just you, but the people you care about, too. We’re making sure your career works for the whole family.

  • Flexibility to choose the shifts and work arrangements work best for your lifestyle
  • Two weeks of paid parental leave
  • Family planning resources
  • Comprehensive health care for dependents
  • Emergency child and elder care options

A Culture That Cares

At UPMC, you can find a home among people who share your passions and care about who you are.

A Culture That Cares

At UPMC, you can find a home among people who share your passions and care about who you are.

A Culture That Cares

UPMC is a place where you can find a home, no matter your gender, race, sexual orientation, age, or culture, and where you can meet people who share your passions and care about you.

Tools to Reach Your Potential

Once you become a member of our team, the journey doesn’t stop there. UPMC is committed to supporting your growth and helping you build the career of your dreams.

  • Up to $6,000 of annual tuition assistance
  • Ongoing learning via LinkedIn Learning
  • Accelerated career pathways for growth
  • Robust instructor-led education and learning pathways

Tools to Reach Your Potential

Once you become a member of our team, the journey doesn’t stop there. UPMC is committed to supporting your growth and helping you build the career of your dreams.

  • Up to $6,000 of annual tuition assistance
  • Ongoing learning via LinkedIn Learning
  • Accelerated career pathways for growth
  • Robust instructor-led education and learning pathways

Tools to Reach Your Potential

Once you become a member of our team, the journey doesn’t stop there. UPMC is committed to supporting your growth and helping you build the career of your dreams.

  • Unlimited educational possibilities, including no-cost BSN and MSN programs
  • Robust career ladders for every nurse – no matter your specialty, location, or career stage
  • Up to $6,000 of annual tuition assistance
  • Ongoing learning opportunities

Expansive Opportunity

Where do you want to go with your career? Wherever it is, UPMC can take you there.

Expansive Opportunity

Where do you want to go with your career? Wherever it is, UPMC can take you there.

Expansive Opportunity

Where do you want to go with your career? Wherever it is, UPMC can take you there.

* Note: Benefits described may not be applicable to all staff.

Read More about Nursing at UPMC

Keshon, a younger male nurse, wears blue scrubs outside a hospital, looks at camera with a soft smile on his face.

Through tuition assistance and mentorship by coworkers, Keshon launched his nursing career in his hometown of McKeesport.

Jouli wears blue scrubs in a hospital room, looks at camera with a soft smile on her face.

Since growing up in Syria, Jouli H.’s story has been one that inspires all of us to remember how empowerment can truly change someone’s life.

Collage of four photos of medical-surgical nurses, all smiling.

We asked our nurses to shed some light on what Med-Surg nursing means to them. Get to know Med-Surg nursing – in four words – from UPMC nurses!

Read More about UPMC Insurance Services Division

Collage of four photos of medical-surgical nurses, all smiling.

In UPMC Insurance Services Division, analysts work to understand, innovate, and improve the products and services UPMC provides.

Young man smiles at camera in a studio setting.

Eddie S. shares how his passion for football, fishing, and friendship shapes his life and his career with UPMC Health Plan.

Veteran outside hiking.

We asked our nurses to shed some light on what Med-Surg nursing means to them. Get to know Med-Surg nursing – in four words – from UPMC nurses!

Similar Jobs

Hospital/Inpatient Coder II
Health Information Management
Work From Home, US-
Posted: 15 days ago
Clinical Documentation Improvement (CDI) Specialist - UPMC Carlisle
Health Information Management
Carlisle, PA
Posted: 23 days ago
Scribe/Medical Writer - GLPP Cardiology
Health Information Management
Jamestown, NY
Posted: 73 days ago

Similar Jobs

VP, Managed Long-Term Services and Supports
Other
Pittsburgh, PA
Posted: 1 days ago
LifeSolutions Care Manager
Behavioral Health
Work From Home, US-
Posted: 1 days ago
Senior Sales Executive, Mid Markets
Marketing, Comm., & Sales
Pittsburgh, PA
Posted: 2 days ago
Actuarial Analyst II- Value Based Contracting
Accounting & Finance
Pittsburgh, PA
Posted: 2 days ago
Clinical Care Manager (RN) - Allegheny County
Nursing
Pittsburgh, PA
Posted: 3 days ago

Get the Inside Scoop

Curious about the culture, roles, and people at UPMC Enterprises? Explore our blog to learn what it’s like working at Enterprises and learn about the passions and perspectives of the folks who make up our UPMC team.

Two women in an office kitchen talking and smiling.

Get the Inside Scoop

Curious about the culture, roles, and people here at UPMC? The UPMC Careers blog is a great place to read more employee stories, get career tips, and learn about the passions and perspectives of folks who make up our UPMC team.

Bearded man in his fifties softly smiles on a charming street in Pittsburgh

Join Our Talent Community

Whether you’ve already applied or are just interested in learning more, stay connected with our team and get updates about career opportunities with UPMC.