Clinical Risk Educator

Summary

Join Aledade as a Clinical Risk Educator and enhance clinical documentation practices. You will develop and deliver educational content to improve documentation accuracy for various audiences, utilizing data trends to identify learning opportunities. Collaborate with colleagues to design educational materials aligned with regulatory compliance and value-based care. Your expertise in clinical documentation will significantly impact how teams deliver care. This remote position is open to candidates nationwide. Aledade offers a comprehensive benefits package including flexible work schedules, health insurance, paid time off, parental leave, and more.

Requirements

• Bachelor’s degree in a healthcare related field or equivalent work experience
• 5+ years of clinical experience
• 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. through AAPC, ACDIS, or AHIMA
• 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 work load 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

Responsibilities

• Conduct educational sessions for Aledade ACO member practices and their key staff on clinical documentation and risk concepts, delivered either in person or virtually
• Serve as an individual contributor on the Risk Education team, collaborating with team members to develop and update educational materials related to clinical documentation, coding and billing for both internal and external audiences. Conduct ongoing annual reviews of repository content to ensure alignment with CMS regulatory updates
• Analyze clinical process measures and outcome data, informed by CDI chart reviews, market performance, and field team input, to identify knowledge gaps and opportunities. Address and clarify missing, unclear, conflicting, or non-compliant information captured by the CDIS, providing clear explanations and guidance to clinicians
• Research, investigate and remain up to date on both clinical and coding guidelines as they relate to clinician documentation improvement
• Serve as a resource for appropriate clinical documentation and coding practices for assigned Regional Market

Preferred Qualifications

• 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

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