Clinical Quality Documentation Specialist, Full-time, Days, Hybrid (Sign-on bonus eligible)
Company: Northwestern Memorial Healthcare
Location: Chicago
Posted on: February 28, 2026
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Job Description:
Job Description Job Description Company Description At
Northwestern Medicine, every patient interaction makes a difference
in cultivating a positive workplace. This patient-first approach is
what sets us apart as a leader in the healthcare industry. As an
integral part of our team, you'll have the opportunity to join our
quest for better health care, no matter where you work within the
Northwestern Medicine system. We pride ourselves on providing
competitive benefits: from tuition reimbursement and loan
forgiveness to 401(k) matching and lifecycle benefits, our goal is
to take care of our employees. Ready to join our quest for better?
Job Description The Clinical Quality Documentation Specialist I
reflects the mission, vision, and values of NM, adheres to the
organization’s Code of Ethics and Corporate Compliance Program, and
complies with all relevant policies, procedures, guidelines and all
other regulatory and accreditation standards. The Clinical Quality
Documentation Specialist I position facilitates improvement in the
overall completeness and accuracy of quality data and outcomes
through extensive interaction with physicians, nursing staff,
interdisciplinary quality committees, multidisciplinary teams and
clinical coders. The Clinical Quality Documentation Specialist I
applies clinical expertise, knowledge of the national Quality
agenda, professional nursing standards, current research, best
practices, and interdisciplinary collaboration to advance problem
analysis and creative process redesign for clinical documentation.
The Clinical Quality Documentation Specialist I acts as a change
agent to systematically drive and implement change as prioritized
by Clinical Documentation Leadership and Senior Clinical and Senior
Quality leadership and/or through the quality and safety
committees. Participates in performance improvement initiatives,
receives and monitors control plans and data trends under the
purview of the Clinical Documentation and Clinical Quality Programs
and in collaboration with clinical interdisciplinary quality
committees and physician practices. Key to this role is the ability
to compel changes in documentation through in-person interaction to
facilitate accurate representations of patient characteristics
within the medical record so that process and outcome measures
based on documentation reflect performance accurately.
Responsibilities: In partnership with Clinical Documentation
Leadership and the Medical Directors of Clinical Documentation,
maintains integrated relationships with business unit and system
physician and administrative leaders to advance quality metrics
through front-line documentation efforts. Rounds daily with
physician and advanced practice providers (APPs) in assigned
service line(s) or business units to ensure appropriate and
accurate documentation in the medical record. Ensures the level of
services and acuity of care will accurately be reflected in quality
outcomes. Partners with operational and medical leadership in a
given service line or business unit to identify, develop and
implement successful communication and education, to engage
physicians and improve processes and outcomes. Performs daily
medical record reviews in assigned service line(s). Performs data
collection activities to identify documentation issues, quality
issues, and opportunities for improvement in patient care and
services. Basic understanding of clinical documentation through the
lens of local and national quality and ranking methodologies,
including but not limited to, U.S. News and World Report, Vizient,
Leapfrog, the CMS Star Rating, and payer contracts and assists the
Managers of Clinical Documentation in execution of and maintenance
of key strategies to effect change. Understands the basics of
leveraging their NM network to initiate conversations, identify
root causes and resolution, and align resources. Analyzes quality
and patient safety data to identify patterns in the management of
patient care and services using reported 1.) Hospital acquired
conditions, 2) Patient safety indicators, 3) Case Mix index, and 4)
Expected mortality. Collaborates with the Clinical Quality Team to
model, teach and improve upon the culture of safety with shared
improvement in all venues. Presents updates to operational and
medical leadership, attending and resident physicians and
interdisciplinary quality committees. Communicates effectively and
collaborates with colleagues and the Clinical Coding Team. Fosters
an environment to execute a shared vision in creating a model of
best practice in the accurate reporting of patient diagnoses,
comorbid conditions and treatment rendered. Professional
Development and Education: Masters evidence and literature in
relevant clinical area, discipline, and improvement science,
including clinical quality improvement, patient safety, human
factors, failure modes, root cause analysis, and related
performance and safety resources. Applies knowledge of professional
nursing standards, best practices, and interdisciplinary
collaboration to advance problem analysis and resolution and
creative process redesign. Other: Participates in a minimum of one
NM Clinical Documentation committee as approved by Manager,
Clinical Documentation Participates on departmental and hospital
committees and task-forces as assigned. Participates in concurrent
performance improvement activities and on-going review activities.
Performs other job-related duties as requested, including special
projects. Complies with Northwestern Memorial Hospital policies on
patient confidentiality including HIPPA requirements and Personal
Rules of Conduct. Qualifications Required: Registered Nurse in the
State of Illinois Bachelor’s or Master’s degree in nursing Minimum
2 years of experience of bedside nursing care and participation in
clinical quality, patient safety, or related initiatives with
evidence of effective change management skills. Must possess and
consistently demonstrate: Strong interpersonal, communication,
conflict management, diplomacy and negotiation skills. Proven
leadership to affect positive clinical quality outcomes. Analytical
skills necessary to independently collect analyze and interpret
clinical data. Basic computer skills and willingness to learn
computer applications relative to this position Preferred: Master’s
Degree Five years’ experience in medical/ surgical, critical care,
intensive care or emergency care preferred Additional Information
Northwestern Medicine is an equal opportunity employer (disability,
VETS) and does not discriminate in hiring or employment on the
basis of age, sex, race, color, religion, national origin, gender
identity, veteran status, disability, sexual orientation or any
other protected status. Background Check Northwestern Medicine
conducts a background check that includes criminal history on newly
hired team members and, at times, internal transfers. If you are
offered a position with us, you will be required to complete an
authorization and disclosure form that gives Northwestern Medicine
permission to run the background check. Results are evaluated on a
case-by-case basis, and we follow all local, state, and federal
laws, including the Illinois Health Care Worker Background Check
Act. Benefits We offer a wide range of benefits that provide
employees with tools and resources to improve their physical,
emotional, and financial well-being while providing protection for
unexpected life events. Please visit our Benefits section to learn
more. Sign-on Bonus Eligibility: Internal employees and rehires who
left Northwestern Medicine within 1 year are not eligible for the
sign on bonus. Exception: New graduate internal employees seeking
their first licensed clinical position at NM may be eligible
depending upon the job family.
Keywords: Northwestern Memorial Healthcare, Elkhart , Clinical Quality Documentation Specialist, Full-time, Days, Hybrid (Sign-on bonus eligible), Healthcare , Chicago, Indiana