Clinical Risk Educator, Remote

Aledade; Charlotte (NC); Remote; USD 60,000 - 100,000; Full time

Job summary

An established industry player is seeking a Clinical Risk Educator who is dedicated to enhancing clinical documentation practices and fostering a culture of learning. In this dynamic role, you will develop and deliver educational content aimed at improving documentation accuracy for a diverse audience, including clinicians and administrative staff. Your expertise will guide teams in navigating clinical documentation challenges, ensuring compliance with regulatory standards while supporting value-based care initiatives. If you thrive in collaborative environments and are passionate about education, this opportunity is perfect for you.

Qualifications

• 5+ years of clinical experience and current medical coding certification required.
• Extensive knowledge of ICD-10-CM, HCPCS, and CPT coding is essential.

Responsibilities

• Conduct educational sessions on clinical documentation for Aledade ACO member practices.
• Analyze clinical data to identify knowledge gaps and improve documentation practices.

Skills

Clinical Documentation Improvement

Medical Coding

Data Analysis

Presentation Skills

Collaboration

Flexibility

Education

Bachelor's degree in a healthcare related field

Current medical coding certification

Tools

Google Meet

Zoom

Google Slides

PowerPoint

Job description

At Aledade, we’re looking for a Clinical Risk Educator who is passionate about enhancing clinical documentation practices and fostering a culture of learning and improvement. In this role, you’ll develop and deliver educational content aimed at improving the accuracy and completeness of clinical documentation for a wide range of audiences, including clinicians, billers, coders, and both clinical and non-clinical staff at Aledade.

As a Clinical Risk Educator, you’ll utilize data trends from CDI outcomes to pinpoint learning opportunities for clinical teams, collaborating closely with colleagues and leadership to design educational materials that align with regulatory compliance and value-based care principles. Your expertise in clinical documentation, combined with your dedication to promoting high-quality and compliant practices, will have a meaningful impact on how our teams deliver exceptional care.

If you're someone who thrives in an educational role, values collaboration, and is committed to improving documentation practices in a value-based care environment, we encourage you to apply.

Candidates should be comfortable working remotely/work from home anywhere within the US.

Primary Duties:

• 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.

Minimum Qualifications:

• Bachelor’s degree in a healthcare related field or equivalent work experience required
• 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 is required
• 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

Preferred KSA's:

• 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