Clinical Nurse Consultant I - CDI & Risk Adjustment Role

Vatica Health; United States; Remote; USD 45,000 - 65,000; Full time

Benefits offered by this job

Bonus potential

401(k) plan

Comprehensive Medical, Dental & Vision

Life Insurance

Short-term Disability

Long-term Disability

Paid time off

Job summary

Vatica Health, Inc. is seeking a Clinical Nurse Consultant I for a remote role focused on CDI and risk adjustment.

You will review chart data, evaluate active conditions, and communicate findings to providers to support accurate documentation and care gap closure. The role blends bedside nursing expertise with health informatics and requires independent workload management in a primarily remote environment with occasional travel for training.

Qualifications

• Active, unrestricted RN license.
• Minimum of three years RN clinical experience assessing complex patient conditions.
• Demonstrated clinical judgment evaluating conflicting information.
• Clear, professional communication of findings to providers.
• Proficiency with EMRs and web-based applications.
• Independent workload management in a remote environment.

Responsibilities

• Review and synthesize information from EMRs and payer data to build accurate patient status.
• Evaluate evidence for active conditions relevant to risk adjustment and support documentation decisions.
• Reconcile conflicting clinical information.
• Identify care gaps and communicate findings to practice teams for follow‑up.
• Complete chart reviews within productivity targets while ensuring quality.
• Build relationships with providers and office staff; follow up to meet deadlines.
• Train and support providers on company technology and workflows.
• Share best practices with colleagues to ensure consistency.

Skills

RN license

EMR proficiency

Clinical chart review

Remote collaboration

Communication skills

Education

Tools

EMR systems

Job description

Clinical Nurse Consultant I - CDI & Risk Adjustment Role — Remote

This role sits at an interesting intersection of clinical nursing and health informatics — a high-growth niche as value-based care and risk adjustment continue to expand across the US healthcare system.

• Clinical Documentation Improvement (CDI) — increasingly in demand as CMS tightens risk adjustment oversight
• EMR proficiency across multiple platforms, translatable to healthcare IT roles
• Risk adjustment and quality measure expertise, valuable for roles at health plans, consulting firms, and ACOs
• Provider relations and clinical education — foundational for healthcare management tracks

Compensation benchmark: At $33–$47/hr, this is competitive for a remote RN consultant role. Mid-career CDI specialists typically earn $70K–$95K nationally; this range aligns well, with upside at the higher end for experienced candidates.

Green flags:

• Defined, production-based work structure suits high performers who want measurable output over office politics
• Growing industry segment — risk adjustment and quality reporting are non-negotiable for health plans
• Explicit mention of career advancement and bonus potential

Potential considerations:

• "Clinical production role" language signals quota-based performance measurement — confirm targets during interview
• Entry-level consultant title ("I") suggests a defined ladder; ask about promotion timelines to Consultant II
• CDI experience is "strongly preferred" — without it, expect a steeper onboarding curve

Overall, this is a solid stepping stone for bedside RNs transitioning into health informatics, utilization management, or payer‑side clinical roles.

Vatica Health and Cozeva bring together clinical expertise and technology to support risk adjustment, quality, and value‑based care. Our teams help providers and health plans use clinical information to improve documentation and identify care gaps.

As a Clinical Nurse Consultant I, you will use your clinical judgment to turn information from medical records and payer data into clear findings that help providers accurately document member conditions and identify gaps in care. You will work directly with providers and practice teams, combining detailed chart review with relationship building and technology support.

This clinical production role requires independent workload management and consistent performance against chart completion and quality standards. Work is primarily remote, with travel to provider offices for training as needed.

Responsibilities

• Review and synthesize information from electronic medical records (EMRs), payer files, and other clinical sources to build an accurate view of each member's documented clinical status.
• Evaluate clinical evidence for active conditions relevant to the applicable risk adjustment model and present findings to support provider condition validation decisions.
• Reconcile conflicting or incomplete clinical information.
• Identify open quality‑of‑care gaps and communicate findings to practice teams for follow‑up.
• Complete chart reviews within established productivity targets and deadlines while meeting quality assurance standards for accuracy and compliance.
• Build effective relationships with providers and office staff and follow up on outstanding items to meet deadlines.
• Train and support providers and practice staff on company technology and workflows, including onsite training as needed.
• Share clinical knowledge and best practices with colleagues to support consistent, accurate chart reviews.

Requirements

• Active, unrestricted Registered Nurse (RN) license.
• Minimum of three years of recent RN clinical experience assessing complex patient conditions and interpreting clinical documentation.
• Demonstrated clinical judgment in evaluating conflicting information and identifying documentation gaps.
• Clear, professional communication of clinical findings and documentation questions to providers and practice staff.
• Proficiency with EMRs and web‑based applications, including navigating multiple systems and learning new technology independently.
• Demonstrated success managing detailed clinical work against productivity, accuracy, and deadline expectations.
• Effective independent workload management and collaboration in a remote team environment.
• Ability to travel occasionally to local provider offices, with access to a personal vehicle or other reliable transportation.

Preferred Qualifications

• RN experience in acute care, critical care, or an emergency department.
• Clinical Documentation Improvement (CDI) experience strongly preferred.
• Knowledge of diagnosis coding, billing concepts, quality measures, and risk adjustment models.

Prosperity

• Competitive salary based on your experience and skills
• Bonus potential (discretionary, based on role)
• 401(k) plans
• Room for growth and advancement

Good Health

• Comprehensive Medical, Dental, and Vision insurance plans
• Tax‑free Dependent Care Account
• Life insurance, short‑term, and long‑term disability

Happiness

• Great work‑life balance environment
• Strong, supportive teams

Compensation: $33–$47 per hour, equivalent to $68,640–$97,760 annually based on a 40‑hour workweek. The starting rate within this range will reflect relevant experience, certifications, and geographic location.

Is the Clinical Nurse Consultant I role fully remote? The role is primarily remote, but occasional travel to local provider offices is required for onsite training and support. You will need access to a personal vehicle or reliable transportation. What is the pay rate for this position? Compensation ranges from $33 to $47 per hour, equivalent to approximately $68,640–$97,760 annually based on a 40‑hour workweek. The starting rate reflects your experience, certifications, and geographic location. Do I need CDI experience to apply? CDI experience is strongly preferred but not explicitly required. A minimum of three years of RN clinical experience assessing complex conditions and interpreting clinical documentation is required. What type of nursing background is best suited for this role? Candidates with acute care, critical care, or emergency department RN experience are preferred. Knowledge of diagnosis coding, quality measures, and risk adjustment models is a plus. What benefits does Vatica Health offer for this position? Benefits include comprehensive medical, dental, and vision insurance, a 401(k) plan, life and disability insurance, a tax‑free dependent care account, bonus potential, generous PTO, and career advancement opportunities.

Remote work & career advice that actually works.