[Hiring] Clinical Risk Educator @Aledade

Role Description

The Clinical Risk Educator is responsible for developing and delivering educational content designed to improve accurate and complete clinical documentation practices. This role supports the clinical audiences of our external partner practices as well as Aledade’s clinical and non-clinical staff internally.

• Perform qualitative retrospective chart reviews for prioritized practices to ensure complete and accurate clinical documentation.
• Utilize quantitative measures to track the frequency and types of documentation errors and gaps.
• Analyze review outcomes to pinpoint specific areas for improvement in coding and clinical documentation.
• Synthesize concise, high-level summaries to illustrate findings and prioritize recommendations for improvement.
• Conduct educational sessions for Aledade ACO member practices and their key staff, delivered either in person or virtually.
• Collaborate with team members to develop and update educational materials related to clinical documentation.
• Conduct ongoing annual reviews of repository content to ensure alignment with CMS regulatory updates.
• Research and remain up to date on clinical and coding guidelines as they relate to clinician documentation improvement.
• Serve as a resource for appropriate clinical documentation and coding practices for assigned region.

Qualifications

• Bachelor’s degree in a healthcare related field or equivalent work experience required.
• 5+ years of clinical experience (in particular nursing or international medical backgrounds).
• Current medical coding certification such as Certified Professional Coder (CPC), Certified Coding Specialist - Physician-based (CCS-P), Certified Risk Adjustment Coder (CRC), Certified Clinical Documentation Specialist (CCDS), Certified Documentation Expert Outpatient (CDEO), Certified Clinical Documentation Specialist-Outpatient (CCDS-O), etc.
• 2+ years of clinical documentation improvement experience.
• Extensive knowledge of ICD-10-CM, HCPCS and CPT coding, medical terminology, human anatomy and physiology, clinical indicators associated with disease processes and pharmacology.
• Subject matter expertise on the CMS HCC Risk Adjustment program, methodology, and impact to value-based contracts.
• Comfortable presenting to large and small groups in person and in virtual format (Google Meet, Zoom, etc.).
• Ability to work both independently and collaboratively.
• Flexible and able to multi-task and prioritize workload on a daily basis.
• Availability for market-specific events, including the execution of 1-2 Saturday events per year in select markets.
• Flexibility to work occasional evening hours, with the potential for 1-2 evenings per month on a national scale.

Requirements

• Active nursing credential as Registered Nurse (RN), Licensed Practical Nurse (LPN), or international medical graduate (IMG).
• Background in working directly with providers in an outpatient setting.
• Experience developing and delivering clinical education and training via Google Slides or Powerpoint presentations.
• Ability to use insights from clinical and quality data to address opportunities for improvement.
• Advanced knowledge of Medicare billing and coding regulations, along with a deep understanding of CMS compliance standards and guidelines.
• General understanding of the billing requirements and reimbursement structures for FQHCs/RHCs.
• Willingness to travel as needed to Aledade’s headquarters or markets.

Physical Requirements

• Sitting for prolonged periods of time.
• Extensive use of computers and keyboard.
• Occasional walking and lifting may be required.
• Willingness to travel as needed to Aledade’s headquarters or markets (est. up to 25% across the year).

Benefits

• Flexible work schedules and the ability to work remotely are available for many roles.
• Health, dental and vision insurance paid up to 80% for employees, dependents and domestic partners.
• Robust time-off plan (21 days of PTO in your first year).
• Two paid volunteer days and 11 paid holidays.
• 12 weeks paid parental leave for all new parents.
• Six weeks paid sabbatical after six years of service.
• Educational Assistant Program and Clinical Employee Reimbursement Program.
• 401(k) with up to 4% match.
• Stock options.
• And much more!