Clinical Documentation Integrity Specialist - Registered Nurse

myPlace Health is built around a simple but powerful belief: older adults deserve the support they need to live safely, independently, and with dignity in their own communities. As a PACE (Program of All Inclusive Care for the Elderly) organization backed by SCAN Group, myPlace Health brings together customized medical care, social activities, and daily support for participants and their families – all under one roof. Our centers are more than healthcare facilities. They are vibrant community hubs where participants are known by name, valued, and supported as whole people. Behind that experience is a dedicated, interdisciplinary team working together to coordinate care, remove barriers, and improve quality of life for some of the most medically and socially complex populations. For employees, myPlace Health offers the opportunity to do deeply meaningful work in a highly collaborative setting. Team members are encouraged to contribute innovative ideas, and grow alongside a mission that prioritizes compassion, respect, and impact. The result is a culture where people feel connected—to their colleagues, their participants, and the communities they serve. At myPlace Health, work is more than a job. It’s a shared commitment to honoring what matters most. The Clinical Documentation Integrity (CDI) Specialist supports accurate, complete, and clinically specific provider documentation across the myPlace Health participant population. This clinically credentialed role partners with providers, interdisciplinary care teams, and risk adjustment stakeholders to ensure documentation reflects each participant’s clinical complexity, disease burden, severity of illness, and care needs. Operating within the PACE model, the CDI Specialist conducts clinically supported chart reviews, identifies documentation opportunities, and collaborates with physicians, nurse practitioners, and care teams to support compliant CMS-HCC capture and sustainable documentation improvement. **RESPONSIBILITIES:** - Conduct prospective, concurrent, and retrospective reviews of medical records to identify documentation gaps, unsupported diagnoses, missed HCC opportunities, and clinically present conditions requiring provider assessment or clarification. - Apply clinical reasoning to synthesize information across EMR documentation, laboratory results, imaging reports, medications, specialist notes, and outside records to support accurate and clinically specific documentation. - Review longitudinal chart trends to identify disease progression, chronic condition indicators, and opportunities to improve documentation of participant complexity and severity of illness. - Formulate compliant verbal and written provider queries that present clinical evidence objectively and support provider clarification without directing clinical conclusions. - Partner directly with physicians, nurse practitioners, and clinical teams through chart-side discussion, consultation, and structured education to improve documentation quality and compliant CMS-HCC capture. - Participate in interdisciplinary team meetings and clinical workflows to surface documentation opportunities in real time and support accurate reflection of participant care needs. - Prioritize and manage daily chart review workflows based on risk stratification, HCC capture opportunities, documentation trends, and organizational priorities. - Track provider documentation patterns, query outcomes, capture rates, and review activity using CDI tracking tools and reporting systems to support program monitoring and audit readiness. - Develop and support provider-facing education, CDI resources, query templates, workflow guides, and performance reports aligned with CMS documentation standards and organizational policy. - Conduct documentation quality reviews and escalate documentation deficiencies, unsupported diagnoses, condition validation concerns, compliance risks, and systemic trends to CDI program leadership. - We seek Rebels wh…